A clinical and etiological study of ophthalmoplegia at a tertiary care hospital in South India.

Background: Appropriate management of ophthalmoplegia demands good anatomy knowledge of cranial nerves involved i.e., III, IV and VI. Where these nerves originate and where they end, clinical features associated with paralysis of each nerve all this knowledge help in proper management of cases. Objective: To study clinical and etiological factors associated with the ophthalmoplegia. Methods: Prospective, Hospital based observational study was carried out among 50 cases of ophthalmoplegia. Detailed history was recorded. Thorough clinical examination including examination of both the eyes was carried out in terms of laterality, pupils affected or not, Central nervous system involvement, cranial nerves III, IV and VI etc. Papilledema, blood pressure, fasting blood sugar were investigated for each case. Results: Most common age group affected was >50 years in 50%. Males were slightly more affected than females. Majority (72%) cases were bilateral. Only nine cases had affected pupils. In ten cases, central nervous system was affected. Hypertension was seen in 32% and diabetes in 44%. 14% had history of trauma. Inflammation, tumor and vascular affection was seen in three cases each. Four cases had viral infection. Among all factors, diabetes was significantly associated with III cranial nerve involvement (p<0.05). Hypertension was significantly associated with IV cranial nerve involvement (p<0.05). But no factor was significantly associated with VI cranial nerve involvement (p>0.05). Conclusion: We conclude that ophthalmoplegia mainly affects elderly and males. It is usually bilateral and sometimes pupils and CNS are affected. Hypertensives and diabetics are at an increased risk of ophthalmoplegia. [ABSTRACT FROM AUTHOR]