Sixth nerve palsy may affect one or both eyes, depending on its cause.
The most common symptom of sixth nerve palsy is double vision when both eyes are open. This is more common when looking far away or when looking in the direction of the affected eye. But not everyone with sixth nerve palsy has this symptom.
The eyes may also be out of alignment, a symptom called strabismus. The eye on the affected side may drift toward the midline. Early on, you might show this symptom only when looking in the direction of the affected eye (like looking to the right in a right sixth nerve palsy). If the palsy worsens, the affected eye may drift toward the midline, even when looking straight ahead.
If you have non-isolated sixth nerve palsy, additional symptoms may be present as well. Depending on the other structures affected, you might have symptoms such as:
- Hearing loss
- Facial weakness
- Decreased facial sensation
- Droopy eyelid
- Nausea and vomiting