---
title: What are third nerve palsy symptoms?
description: "Third nerve palsy affects the oculomotor nerve, which controls most eye movements and eyelid elevation. Symptoms can be dramatic. ## Typical signs and symptoms The affected eye often turns outward and downward because opposing muscles are unbalanced. Double vision is…"
url: "https://bluefinvision.com/knowledge-base/topics/symptoms-signs/what-are-third-nerve-palsy-symptoms/"
updated: "2025-12-31"
category: "Symptoms & Signs"
---

# What are third nerve palsy symptoms?

Third nerve palsy affects the oculomotor nerve, which controls most eye movements and eyelid elevation. Symptoms can be dramatic.

## Typical signs and symptoms

The affected eye often turns outward and downward because opposing muscles are unbalanced. Double vision is common.

- Drooping upper eyelid ptosis
- Eye turned outwards and slightly down
- Double vision that improves when one eye is covered
- Possible enlarged pupil that reacts poorly to light

## Why urgent assessment is crucial

Some third nerve palsies are caused by aneurysms or other serious brain problems. Early diagnosis can be life-saving.

- Sudden-onset palsy with a large pupil is especially concerning
- Severe headache or other neurological symptoms add urgency
- Imaging of the brain and blood vessels is usually required
- Diabetes-related palsies may spare the pupil but still need evaluation