Ophthalmoplegia is paralysis of muscles that control the movement of eyes. These muscles also keep the eye well placed in the socket. There are six muscles that control the eye movement. Paralysis or weakness can develop in one or more than one muscle of eye.
The cause of ophthalmoplegia can be related to disorders of muscles, thyroid problem, stroke or other neurological conditions usually affecting the 3rd, 4th and 6th cranial nerves. Opthalmoplegia can be described in two forms. It can be either chronic progressive external opthalmoplegia or internuclear opthalmoplegia. Treatment of this eye disease depends on the type of ophthalmoplegia and its underlying cause.
Types Of Ophthalmoplegia
As mentioned above ophthalmoplegia can be of two types; external opthalmoplegia and internuclear opthalmoplegia. External ophthalmoplegia affects adults between mid twenties and forties. It is characterized by drooping eyelids and difficulty in controlling the muscles that control eye movement.
Internuclear opthalmoplegia occurs when the nerve fibers that control the side to side movement of both the eyes is damaged. These fibers originate from certain cranial nerves. Internuclear opthalmoplegia is more common in older age group suffering from stroke and in young people suffering from multiple sclerosis.
Less common cause is head trauma.Patients suffering from this condition often complain of double vision.
What Causes Ophthalmoplegia?
Opthalmoplegia is an ocular condition related to abnormal movement or eye due to paralysis of eye muscles involved in movement of eyes. This disorder can develop in one or both the eyes. Drooping of the upper eyelid is one of the primary symptoms indicative of opthalmoplegia. It can be the earliest manifestation of this eye condition. Drooping is soon accompanied with other symptoms such as blurred vision or double vision.
In this disease depending on the type, the affected eye may not move in sync horizontally. The eye drifts downwards and slightly outwards however it becomes difficult to turn it inwards and upwards. The pupil is large and dilated.
Pupil is the round hole that you see in the center of the eye. It usually constricts when direct light falls on it and dilates in darkness. But if it dilates extremely there is possibility of cerebral aneurysm or some other neurological problem.
Signs And Symptoms Of Ophthalmoplegia
There are multiple causes of opthalmoplegia. The disorder can be since birth or may be develop after birth. The basic reason of opthalmoplegia is disruption in the signals sent by brain to the eye muscles which control its movement. The main reason for internuclear opthalmoplegia is stroke, multiple sclerosis or injury to eye or brain.
Muscle disorders are responsible for most cases of external opthalmoplegia. This may include muscle disorders such as myasthenia gravis, Kearns-sayre syndrome etc. The less common causes of opthalmoplegia include migraine attacks, thyroid disease, brain tumor, infection in brain such as meningitis and encephalitis, syphilis.
Side effects of certain drugs, especially antidepressants and phenothiazine can also produce eye muscle weakness. People with diabetes are at greater risk of developing the disease.
Treatment Of Ophthalmoplegia
Several factors have to be taken into consideration while treating opthalmoplegia. The type of opthalmoplegia, symptoms developing and the underlying etiology are the three important elements considered by an opthalomologist while treating a patient with this condition. The aim is to correct communication between the cranial nerves and the muscles of eye in case of internuclear opthalmoplegia.
Anti viral drugs or antibiotics may be needed if the underlying cause is viral or bacterial disease. Corticosteroids may be necessary if there is edema in brain. It helps to reduce intracranial pressure. Wearing certain type of specific glasses or wearing an eye patch will help to eliminate double vision.