Common Causes Of Ophthalmoplegia

Ophthalmoplegia is paralysis or weakness of the eye muscles. Six muscles hold the eye in place and control its movements, and any one of these can be affected leading to ophthalmoplegia. There are two types of ophthalmoplegia: chronic progressive external and internuclear. Chronic progressive external ophthalmoplegia usually occurs in adults between eighteen and forty years old. Internuclear ophthalmoplegia occurs due to nerve damage to the nerve fibers that coordinate lateral movements of the eye. Individuals affected with ophthalmoplegia may experience double vision or blurred vision, or they may experience drooping eyelids or difficulty controlling eye muscle coordination. Get to know the common causes of ophthalmoplegia now.

Graves' Disease

Some individuals with Graves’ disease, an autoimmune condition that affects the production of thyroid hormone, develop a condition called Graves’ ophthalmopathy, which is also known as thyroid eye disease. Graves’ ophthalmopathy affects the muscles and tissues around the eyes. The most characteristic finding of Graves’ ophthalmopathy is bulging of the eyeballs, known as exophthalmos. Other common symptoms include lid retraction, swollen eyelids, light sensitivity, and double vision. Graves’ ophthalmopathy occurs in about thirty percent of individuals with Graves’ disease and is caused by the immune system attacking the muscles and tissues around the eyes. The inflamed muscles that hold the optic nerve in place can become damaged and if left untreated, may result in vision loss. To decrease eye irritation, artificial tear drops can be used several times a day, and steroids can be given to reduce the eye swelling. As well, if the eyes are protruding a great deal, a surgeon can perform orbital decompression surgery.

Continue reading to learn more about what can cause ophthalmoplegia now.

Brain Tumor Or Injury

A brain tumor or injury are some of the rarest causes of intranuclear ophthalmoplegia. Individuals with a primary central nervous system tumor can develop a bilateral ophthalmoplegia as their disease progresses. This disorder affects the lateral horizontal gaze of the individual, which leads to diplopia. Many cases have been seen of children with brain tumors developing a bilateral ophthalmoplegia as their disease worsens. A head injury has also been seen to be the cause of unilateral ophthalmoplegia, and in rare cases, a head injury has lead to the injury of the medial longitudinal fasciculus in the brainstem, which in turn has caused double vision and headaches.

Discover additional causes of ophthalmoplegia now.

Migraines

Recurrent headaches and ophthalmoplegia can cause a rare neurological condition known as ophthalmoplegic migraines. These are different from other types of headaches, which characteristically have a visual aura. MRI findings have shown migraines have an inflammatory cranial neuropathy. MIgraines will typically present with a transient headache and double vision and a drooping upper eyelid. These types of headaches have been found to usually occur in children, but they have also been reported in adults. Symptoms tend to resolve after an episode, unless the episodes are persistent, in which case some deficits remain. There is still no adequate treatment for migraines, but some doctors have recommended prophylactic medications, such as beta blockers or calcium channel blockers.

Get the details on more common causes of ophthalmoplegia now.

Multiple Sclerosis

Patients with multiple sclerosis, a condition in which the immune system destroys the nerves' protective covering, may also present with intranuclear ophthalmoplegia. Multiple sclerosis generally affects younger individuals and causes intranuclear ophthalmoplegia in both eyes. In this condition, the nerve fibers that coordinate the horizontal movements of the eyes become damaged, leading to blurry vision since both eyes cannot focus on the same object. This impaired horizontal eye movement is due to a lesion in the medial longitudinal fasciculus, which is what causes the eyes not to be able to gaze laterally. Many brainstem syndromes can affect the medial longitudinal fasciculus, but multiple sclerosis is the most common cause of impaired horizontal movements of the eye. In the case of an acute intranuclear ophthalmoplegia, intravenous steroids can be given to the patient.

Unveil another ophthalmoplegia cause now.

Stroke

A stroke causes damage to the brain due to a decrease in blood supply. This condition mostly affects older individuals and can also lead to intranuclear ophthalmoplegia, though unlike multiple sclerosis, it will usually affect only one eye. However, a decreased blood supply to one side of the brain can occasionally cause intranuclear ophthalmoplegia in both eyes, as well. A typical case would commonly occur in an older individual who presented to the emergency department with an acute onset of blurry vision in one eye. After performing diagnostic tests, MRI findings would show an acute infarct in the region of the medial longitudinal fasciculus. A lesion in this region would affect the horizontal gaze of the eye, leading to blurry vision. An ischemic stroke causing intranuclear ophthalmoplegia can occur without any other neurological deficits. The patient would then be treated with blood thinners, such as clopidogrel and acetylsalicylic acid.