Ophthalmoparesis

Causes

Ophthalmoparesis can arise from disorders affecting various parts of the eye and nervous system. Causes include infection around the eye, such as orbital cellulitis; mechanical restrictions within the orbit, as in Graves' disease; muscle disorders like progressive external ophthalmoplegia or Kearns–Sayre syndrome; neuromuscular junction dysfunction, as in myasthenia gravis; cranial nerve involvement (oculomotor, trochlear, abducens) from cavernous sinus syndrome or raised intracranial pressure; brainstem nuclei lesions from strokes such as Foville's syndrome; white matter tract involvement in internuclear ophthalmoplegia, sometimes seen in multiple sclerosis; dorsal midbrain structures in Parinaud's syndrome; cerebral cortex lesions including the frontal eye fields from stroke; toxic envenomation by mambas, taipans, and kraits; thiamine deficiency causing Wernicke encephalopathy; and intoxication with substances like phenytoin.

Did You Know?

• Ophthalmoparesis can involve any or all of the extraocular muscles: superior recti, inferior recti, medial recti, lateral recti, inferior oblique, and superior oblique.
• It can be classified by the directions of affected movements, for example 'vertical ophthalmoparesis'.
• The causal pathway by which thiamine deficiency leads to ophthalmoparesis is unknown.