Choroidal effusion with neurosensory detachment after medial transposition of Y-split lateral rectus in third nerve palsy

Transposition of lateral rectus to medial rectus, though an alluring and effective method in managing complete third nerve palsy, is not without its complications. We report a rare but known complication of choroidal effusion with neurosensory detachment after medial transposition of Y split lateral rectus, in a case of posttraumatic complete third nerve palsy with aberrant regeneration. This led to a severe drop in visual acuity which did not resolve spontaneously and was managed by release of the scleral suture and topical, intravenous, and oral steroids subsequently leading to its complete resolution and restoration of visual acuity.