Objective: To determine the types and frequency of symptomatic ocular motility disturbances following head trauma and their association with severity of trauma.
Design: Retrospective study of patients with (1) diplopia unless visual loss is present, (2) heterotropia for far or near targets, and (3) prior head injury.
Setting: Office and in-hospital consulting practice of a university neuro-ophthalmologist.
Subjects: Sixty patients with posttraumatic ophthalmoplegia.
Main outcome measures: Paralytic and nonparalytic heterotropias were quantitated in prism diopters or percentage limitation of ductions. Convergence insufficiency was assessed by determining the near point of convergence.
Results: Fifty-one patients had nuclear or infranuclear findings, ie, trochlear palsies (n = 20), oculomotor palsies (n = 17), abducens palsies (n = 7), combined palsies (n = 5), and restrictive ophthalmopathy (n = 2). Nine patients had supranuclear dysfunction, including seven patients with convergence insufficiency. Bilateral ocular motor palsies and combined palsies were significantly (by means of chi 2 test) associated with head trauma of severity sufficient to cause corticospinal tract dysfunction. Individual or combined ocular motor palsies were not significantly (by means of chi 2 test) associated with intracranial hemorrhage and/or skull fracture or loss of consciousness.
Conclusions: Trochlear palsy was the most common nuclear or infranuclear basis for traumatic diplopia, and convergence insufficiency was the most common supranuclear cause of double vision. Head trauma distinguished by upper motor-neuron signs was correlated with specific subsets of disordered ocular motility.
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As a committed eye care professional at , Dr. Babakhan often hears the question, "What is the correct way to apply a warm compress?" In response to this common inquiry, we're going to delve into the subject today and offer valuable guidance on this beneficial home remedy for managing dry eye syndrome. Take Our Online […]
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As a caring and passionate optometrists at , our eye doctors, Dr. Babakhan and Dr. Garbus frequently confront a prevalent issue that many patients present during their visits to our centrally located practice in - dry eyes. Dr. Babakhan often gets asked about the best eye drops that can bring relief to this common, yet […]
