Periosteal Fixation for Total Third Nerve Palsy

In this case, presented by Dr. Velez at Pediatric Subspecialty Day 2016, a 67-year-old woman presents with a pituitary tumor and limited adduction in downward gaze. Performing a right lateral rectus muscle recession, right medial rectus muscle plication, right superior oblique medial resection, and transposition has not improved the alignment.