Treatment of sixth nerve palsies is dictated by the underlying causes. Older patients who are thought to have had a mini-stroke are observed for several months, because of likely spontaneous resolution.
Isolated sixth nerve palsies usually manifest as a horizontal diplopia worse when looking towards the affected eye, with a decreased ability to abduct.
Steroids may treat pain and double vision. Special lenses with prisms may improve diplopia. Surgery on the eye muscles or eyelid may be necessary in some cases
Patients afflicted with a sixth nerve palsy should refrain from driving unless an eye patch is used. In addition certain types of employment may warrant a medical leave or temporary change of duties.