Oculomotor nerve palsy presents the greatest challenge in clinical treatment among the other cranial nerves that innervate extraocular muscle. With a complex technique of periosteal fixation using Callahan suture commonly used, a simpler and more effective technique is demanded to be proven. Here we present a case of paralytic exotropia due to oculomotor nerve palsy on a 32-year-old male along with evidence supporting our decision of surgical management. A 32-year-old male with a chief complaint of squint in both eyes was examined at an outpatient eye clinic. The patient had congenital isolated partial oculomotor nerve palsy and the examination revealed severe ptosis on both eyes with 40 prism diopter exotropia and no limitation in the forced duction test. The patient's posterior segment examination showed normal results, and a diagnosis of bilateral paralytic exotropia due to isolated partial oculomotor nerve palsy was considered. The patient underwent a 7.5 mm rectus lateral recession with a 6 mm rectus medial resection on his right eye, with a promising result after a 3-week follow-up. When treating paralytic strabismus resulting from isolated oculomotor nerve palsy, a combination of medial rectus resection and lateral rectus recession yields good results and long-term stability.
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http://dx.doi.org/10.11604/pamj.2024.48.165.44739 | DOI Listing |
BMJ Case Rep
January 2025
Department of General Medicine, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (Deemed to be University), Pondicherry, India.
Idiopathic intracranial hypertension (IIH) is marked by increased intracranial pressure without any accompanying evidence of clinical, imaging or laboratory findings of intracranial pathology. In addition to headache, nausea and vomiting, typical symptoms might also include diplopia, photophobia and blurred vision. Third nerve palsy is rarely linked to IIH, although sixth nerve palsy is reported in the majority of individuals with IIH.
View Article and Find Full Text PDFHeadache
January 2025
Bangalore Medical College and Research Institute, Bangalore, India.
Objective: This systematic review aims to consolidate and analyze the existing evidence on Tolosa-Hunt syndrome (THS) in the pediatric population, focusing on clinical features, diagnostic challenges, treatment outcomes, and prognosis.
Background: Tolosa-Hunt syndrome is a rare headache disorder caused by idiopathic inflammation of the cavernous sinus, orbital apex, or orbit, resulting in neuro-ophthalmological manifestations. It is uniquely characterized by cranial nerve palsies and often responds well to steroids.
J AAPOS
December 2024
Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada.
A 13-month-old boy presented to the pediatric ophthalmology clinic at BC Children's Hospital for strabismus assessment. On examination he had a right facial hemangioma, left ptosis, and left exotropia and hypotropia. Magnetic resonance imaging and magnetic resonance angiography of his head demonstrated posterior cerebral artery tortuosity producing mild mass effect on the left oculomotor nerve.
View Article and Find Full Text PDFZhonghua Yan Ke Za Zhi
January 2025
Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin300052, China.
Zhonghua Yan Ke Za Zhi
January 2025
Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology of Tianjin Medical University, Tianjin Eye Institute, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin300020, China.
To explore the efficacy of the modified lateral rectus muscle splitting and nasal transposition surgery in treating large-angle exotropia caused by oculomotor nerve palsy and its impact on ocular motility. Retrospective case series study. Data was collected from patients diagnosed with large-angle exotropia due to oculomotor nerve palsy and treated by modified lateral rectus muscle splitting and nasal transposition surgery at the Tianjin Eye Hospital from January 2020 to October 2023.
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