Ophthalmoplegia

Ophthalmoplegia

The eye is held in position with the help of 6 eye muscles (extraocular muscles). They are superior, inferior, medial and lateral recti, and superior and inferior oblique muscles. Paralysis of one or more of the muscles of the eye is known as ophthalmoplegia. Ophthalmoplegia is of 3 types - progressive external ophthalmoplegia, supranuclear ophthalmoplegia, and internuclear ophthalmoplegia.

Causes and risk factors

Ophthalmoplegia can be congenital or acquired later in life.

The causes of ophthalmoplegia include genetic disorders, head injury, stroke, tumors in the brain, infections, multiple sclerosis, myasthenia gravis, thyroid disorders, migraine, and deficiency of thiamine.

Clinical presentation

Patients with ophthalmoplegia have a hard time keeping their eye in a normal position. Even eye movements are very difficult. They suffer from blurring of vision, diplopia (double vision), ptosis, and dysphagia (difficulty in swallowing).

The following features can be observed in specific types of ophthalmoplegia:

Internuclear – The patient cannot look from side to side.

Supranuclear – The range of eye movement is limited. Dementia may be present.

Progressive external – Muscular weakness in arms and legs.

Investigations

A complete ophthalmoscopic examination is carried out. If necessary, a CT or MRI scan is performed.

Treatment

Treatment for ophthalmoplegia consists of identifying and treating the underlying cause. Spectacles or eye patches can be used to help improve the vision.

When to contact a doctor

Contact a doctor as soon as you experience any difficulty in eye movement.

Systems involved

Ophthalmology, CNS

Organs involved

Eyes, brain

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