Where Your Dreams Become Reality
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Poster: humble servant
Subject: RE: Fourth Cranial Nerve Palsy
I would recommend giving the glasses a shot, base down prism over the hyper eye, and base up over the fellow eye.
Many patients have benefitted from prismatic correction, which can also alleviate compensating neck problems if present. Seek out a practitioner experienced in optical correction and see if you benefit.
Most of my patients who exhibit "decompensation" of a longstanding palsy or strabismus are usually a little older (>60) but a case like yours is not terribly uncommon.
I am not qualified to comment on your neuro presentation, but obviously you should continue with close monitoring as you stated.
best of luck to you
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