Ophthalmoparesis

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List of terms related to Ophthalmoparesis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Ophthalmoparesis is a physical finding in certain neurologic illnesses. It refers to paralysis of the extraocular muscles which are responsible for eye movements. It can refer to complete paralysis of the eyes, in which case it is synonymous with ophthalmoplegia. More usually, it refers to a partial paralysis, in contrast to the complete paralysis denoted by ophthalmoplegia.

Classification

Ophthalmoparesis can involve any or all of the extraocular muscles, which include the superior recti, inferior recti, medial recti, lateral recti, inferior oblique and superior oblique muscles.

It can also be classified by the directions of affected movements, e.g. "vertical ophthalmoparesis".

Types of ophthalmoplegia are:

• Progressive external ophthalmoplegia
• Supranuclear ophthalmoplegia

Causes

Ophthalmoparesis can result from disorders of various parts of the eye and nervous system:

• The orbit of the eye, including mechanical restrictions of eye movement, as in Graves disease.
• The muscle, as in progressive external ophthalmoplegia or Kearns-Sayre syndrome
• The neuromuscular junction, as in myasthenia gravis.
• The cranial nerves or their brainstem nuclei of the oculomotor, trochlear, and abducens.
• White matter tracts in the brainstem, as in internuclear ophthalmoplegia, an occasional finding in multiple sclerosis.
• Injury to supranuclear structures, as in progressive supranuclear palsy.
• Very rarely, disorders of higher brain structures, including the parietal lobes of the cerebral cortex.

Thiamine deficiency can cause ophthalmoparesis in susceptible persons; this is part of the syndrome called Wernicke encephalopathy. The causal pathway by which this occurs is unknown. Intoxication with certain substances, such as phenytoin, can also cause ophthalmoparesis.

Common Causes

• List the most common causes here.

Causes by Organ System

Cardiovascular	No underlying causes
Chemical/Poisoning	No underlying causes
Dental	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	No underlying causes
Ear Nose Throat	No underlying causes
Endocrine	No underlying causes
Environmental	No underlying causes
Gastroenterologic	No underlying causes
Genetic	No underlying causes
Hematologic	No underlying causes
Iatrogenic	No underlying causes
Infectious Disease	No underlying causes
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	No underlying causes
Nutritional/Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	No underlying causes
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal/Electrolyte	No underlying causes
Rheumatology/Immunology/Allergy	No underlying causes
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	No underlying causes

Causes in Alphabetical Order

• Disease A
• Disease B
• Disease C
• Disease ...

• Disease P
• Disease Q
• Disease R
• Disease ...

• Disease X
• Disease Y
• Disease Z

Differentiating Opthalmoparesis from other Conditions

• Acute cranial polyneuropathy
• Adie syndrome
• Bilateral third nerve involvement
• Botulism
• Brainstem stroke
• Diptheria
• Drugs
• Iris injury
• Meningitis
• Myasthenia gravis
• Tetanus
• Midbrain lesion
• Vasculitis

Treatment

Treatment depend on the underlying condition.

Related Chapters

• Paresis

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