Ophthalmoplegia

Clinic

• It is an entity, also called extraocular muscle palsy
• It usually involves three cranial nerves
  • Third ( CN-3, Oculomotor)
  • Fourth (CN-4, Trochlear)
  • Sixth (CN-6, Abducens)

Sign / Symptoms

Double vision is the characteristic symptom in all three cases.

• In oculomotor paralysis, the eye drifts outward and slightly downward and has difficulty turning inward and upward. In addition, ptosis is occurred. Also pupil may be enlarged
• Trochlear paralysis involve superior oblique, causes a vertical deviation of the affected eye.
• Abducens nerve paralysis affects lateral rectus, therefore the affected eye turns inward toward the nose and cannot fully turn outward.

Causes

• Congenital abnormalities, trauma, tumours
• MS
• Vascular disease such as that associated with diabetes
• Myasthenia gravis