although uncommon, traumatic optic neuropathy (ton) is an important cause of visual loss. different therapeutic approaches including different dosages of steroids, surgical decompression of optic canal and observation alone have been suggested but there has been no conclusive evidence to establish a standard approach to this devastating cause of visual loss. to determine the effectiveness of in...

     Multiple sclerosis (MS) is an inflammatory, demyelinating, neurodegenerative disorder of the central nervous system (CNS) of unknown etiology. Isolated oculomotor nerve palsy is found rarely in children with MS. We present a case of MS in 10-year-old boy, who had bilateral ptosis associated with medial gaze restriction. The extraocular muscle examination demonstrated bilateral adduction pa...

The paradigm that an "underacting" extraocular muscle is always atrophic or hypoplastic and that an overacting extraocular muscle should always be enlarged leads to inconsistencies with clinical observations. These include findings of "overacting" inferior oblique muscles, superior rectus muscle overaction or contracture syndrome, and normal extraocular muscle diameters in patients with apparen...

Five adults with acute extraocular muscle palsies followed by limited recovery of muscle function were treated with injections of botulinum toxin A to the ipsilateral antagonist of the affected muscle. Three were cases of unilateral sixth nerve palsy, one of bilateral sixth nerve palsy, and one of third nerve palsy. After a period of paralysis, during which the strabismus was overcorrected, the...

OBJECTIVE To seek evidence for causative secondary changes in extraocular muscle volume, cross-sectional area, and contractility in superior oblique (SO) palsy using magnetic resonance imaging, given that vertical deviations in SO palsy greatly exceed those explained by loss of SO vertical action alone. METHODS High-resolution, quasi-coronal orbital magnetic resonance images in target-control...

Isolated third nerve palsy develops in numerous intracranial pathologies such as closed head trauma, tumor, and aneurysm. Isolated oculomotor nerve palsy caused by shrapnel injury is uncommon. After a penetrating intracranial shrapnel injury, our patient with oculomotor ophthalmoplegia underwent surgery. Microsurgery removed the shrapnel that was applying pressure on the third nerve, resulting ...

Purpose To investigate changes in volumes of extraocular muscle (EOM) compartments in unilateral superior oblique (SO) palsy using magnetic resonance imaging (MRI). Methods High-resolution, surface-coil MRI was obtained in 19 patients with unilateral SO palsy and 19 age-matched orthotropic control subjects. Rectus EOMs and the SO were divided into two anatomic compartments for volume analysis...

Abducens palsy (ie, sixth nerve palsy) is the most common single extraocular muscle palsy. The primary symptom is double vision. The treatment goal is to correct the underlying cause. If no cause is identified or the palsy is related to a well-managed chronic disease, treatment consists of patching one eye or applying a temporary prism. We report a patient whose abducens palsy resolved with fou...

purpose: to report three cases of classic cranial syndromes with involvement of the third and sixth nerves with comparison of their clinical and radiological findings and results of treatment. case report: three patients were referred to labbafinejad strabismus clinic because of diplopia and eye deviation after an attack of eclampsia (one case) and head trauma (two cases). they had extraocular ...