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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.
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".
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.
Treatment and prognosis Edit
Treatment and prognosis depend on the underlying condition.
Eye disease - pathology of the eye ( H00-H59, 360-379)
eyelid: inflammation ( Stye, Chalazion, Blepharitis) - Entropion - Ectropion - Lagophthalmos - Blepharochalasis - Ptosis - Blepharophimosis - Xanthelasma - Trichiasis - Madarosis
lacrimal system: Dacryoadenitis - Epiphora - Dacryocystitis
orbit: Exophthalmos - Enophthalmos
Optic nerve and visual pathways
Optic neuritis - Papilledema - Optic atrophy - Leber's hereditary optic neuropathy - Dominant optic atrophy - Optic disc drusen - Glaucoma - Toxic and nutritional optic neuropathy - Anterior ischemic optic neuropathy
Ocular muscles, binocular movement, accommodation and refraction
Paralytic strabismus: Ophthalmoparesis - Progressive external ophthalmoplegia - ( Palsy III, IV, VI) - Kearns-Sayre syndrome
Other strabismus: Esotropia/ Exotropia - Hypertropia - Heterophoria ( Esophoria, Exophoria) - Brown's syndrome - Duane syndrome
Other binocular: Conjugate gaze palsy - Convergence insufficiency - Internuclear ophthalmoplegia - One and a half syndrome
Refractive error: Hyperopia/ Myopia - Astigmatism - Anisometropia/ Aniseikonia - Presbyopia
Visual disturbances and blindness
Amblyopia - Leber's congenital amaurosis - Subjective ( Asthenopia, Hemeralopia, Photophobia, Scintillating scotoma) - Diplopia - Scotoma - Anopsia ( Binasal hemianopsia, Bitemporal hemianopsia, Homonymous hemianopsia, Quadrantanopia) - Color blindness ( Achromatopsia, Dichromacy, Monochromacy) - Nyctalopia ( Oguchi disease) - Blindness/ Low vision
Anisocoria - Argyll Robertson pupil - Marcus Gunn pupil/ Marcus Gunn phenomenon - Adie syndrome - Miosis - Mydriasis - Cycloplegia
Trachoma - Onchocerciasis
Nystagmus - Glaucoma/ Ocular hypertension - Floater - Leber's hereditary optic neuropathy - Red eye - Keratomycosis - Xerophthalmia - Phthisis bulbi