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Medical Forum / General / Vision / May 2007

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4th nerve palsy qs

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Simon Dean - 02 May 2007 13:23 GMT
Hi,

You may recall the doc at the eye hospital after MRI's and electrical
testing and all that, and field of vision tests, said I had a fourth
nerve palsy. About six months later I had an appointment with a doc in
relation to an accident I had for an insurance claim.

In his notes, he mentions that all 12 Cranial Nerves are fine.

I wrote a letter back to set the record straight, and this doctor says
along the lines...

"Fourth nerve palsy refers to a vertical misalignment of the eye of
which none was present when I examined Mr Dean..."

etc.

First, I thought it referred to a nerve weakness and problems with
transmitting signals. While congenital FNP might have a common symptom
of vertical misalignment, recent onset can be much more subtle, and my
issues seem to be in tracking from left to right with my eyes. Apparently.

I thought this Doc was a bit cheeky, but, nothing worth complaining
about when taken in context.

But it just makes me think, how many quacks are out there making up
stuff on the spot and trying to say it's real?

Cya
Simon
Scott Seidman - 02 May 2007 13:36 GMT
> Hi,
>
[quoted text clipped - 27 lines]
> Cya
> Simon

I don't think your standard GP would be able to spot a subtle fourth
nerve palsey on a "standard" office visit.  

I don't know the particulars, but I'm pretty sure the differences between
billable office visits (short vs. extended, for example) that docs can
bill for are basically a checklist.  Doing 12 nerves, instead of 8, for
example, might tip the scales to the next higher level.  

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Scott
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Simon Dean - 02 May 2007 14:23 GMT
>> Hi,
>>
[quoted text clipped - 36 lines]
> instead of 8, for example, might tip the scales to the next higher
> level.

This doc (for the accident insurance/claim) I saw was a consultant
orthopaedic surgeon, and accurately diagnosed that all 12 cranial nerves
were fine from "sight" alone.

Thanks doc, but I'd rather trust the experience of the eye hospital whos
excellent care I've been under. It just really amuses me how many of
these doctors are pretending they're expert in everything. If you dont
know, don't comment!
 
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