Ophthalmoplegia is a disorder involving the muscles used to control the movements of the eye. In people with ophthalmoplegia, one or more of these muscles does not function properly and is partially or fully paralyzed. As a result, the involved eye does not move in concert with the other eye. For the patient, this can result in double vision, as one eye moves and the other does not. Also, there may be other complications, depending on the cause of the muscle paralysis.
If the condition is myopathic in origin, it means that there is something physically wrong with the muscle itself, such as degeneration or infection in the muscle tissue. Neurogenic disorders, on the other hand, are the result of a problem in the nervous system that breaks down communication with the eye muscles. Opthalmoplegia can be associated with degenerative neurological conditions like multiple sclerosis, along with infections, nutritional deficiencies, exposure to toxins, and brain injuries.
When a patient presents with ophthalmoplegia, the first step is to do a workup to determine the extent. This examination may involve input from a neurologist, as well as an ophthalmologist. The patient will be asked to guide the eyes through a series of movements. The doctor will take note of the movements where one eye has trouble tracking or does not move at all. This provides information about the involved muscles and nerves. The patient may also have other symptoms, such as a drooping eyelid or partial facial paralysis that must be considered during the evaluation.
A patient interview will be conducted to identify any potential causes and risk factors. The doctor may also recommend testing, including medical imaging of the brain, electromyograms to study muscle movements, and biopsy of the muscles. The tests needed will depend on the nature of the patient's condition and the findings made during the examination. All of this information will be used to develop a diagnosis and determine what is causing the ophthalmoplegia.
Treatment options vary, depending on the cause. For something like a nutritional deficiency, providing the patient with supplements and making some dietary changes may resolve the ophthalmoplegia. In other cases, patients may benefit from surgery, medications, physical therapy, and other treatment options. For some patients, there are no treatments available and the focus is on management of the condition. Wearing a protective eye patch over the affected eye, for example, can resolve double vision problems. Likewise, eye drops can be used to replace lost moisture.
