Presentation (obstetrics)

Engineering

Cranial nerve palsy

Cohort

Diplopia

Surgery

Etiology

Abducens nerve

Psychiatry

Current (fluid)

Alternative medicine

Pediatrics

Cerebral palsy

Retrospective cohort study

Psychology

Physical therapy

Internal medicine

Oculomotor nerve palsy

Palsy

Medicine

Physical medicine and rehabilitation

Sixth nerve palsy

Electrical engineering

Pathology

Asia-Pacific Journal of Ophthalmology

Purpose: To describe the clinical, demographic, and etiological profile of patients of acquired ocular motor palsy presenting in a tertiary eye care center. Design: A retrospective hospital record-based study was conducted in patients of paralytic strabismus presenting from April 2016 to December 2017. Methods: Data included demographic and clinical details, diagnosis, underlying etiology, imaging, laboratory reports, and the outcome. Results: Mean age of presentation of 345 patients included in the study was 38.2 ± 19.5 years (range = 365 years). Pediatric patients (age: ≤16 years) constituted 9.5% of the entire cohort. Mean duration of complaints was 5.87 ± 2 months. Of the 372 eyes of 345 cases, 42.7% were sixth nerve palsy, 34.7% were third nerve palsy, 17.7% were fourth nerve palsy, and 4.8% had multiple ocular motor nerve involvement. Third and sixth nerve palsies were mostly due to ischemic event (58.1% and 69.8% cases, respectively), whereas fourth nerve palsies were commonly caused by trauma (63.6%). Amongst traumatic cases, road traffic accident was the most common mode of trauma. Systemic risk factors were preexistent in 18.2% cases (n = 63); in the remaining (40.8%; n = 141), they were diagnosed after presentation. Complete or partial recovery was noted in 69.7% cases in third nerve palsy, 67.9% cases in sixth nerve palsy, and 45% cases in fourth nerve palsy. Conclusions: Acquired cranial nerve palsy has younger onset in Indian scenario. Ischemia is the most common etiology raising concerns about the health issues of young Indians. Sixth nerve is most commonly involved in all age groups. Low recovery rate in fourth nerve palsy can be attributed to traumatic etiology.

Acquired Ocular Motor Palsy: Current Demographic and Etiological Profile