Neuro-opthalmological aspect of ocular motor abnormalities

Authors

  • V. A. Vasyuta The State Institution "Romodanov Neurosurgery Institute, National Academy of Medical Sciences of Ukraine"; Kyiv (Ukraine)
  • V. V. Biloshytsky The State Institution "Romodanov Neurosurgery Institute, National Academy of Medical Sciences of Ukraine"; Kyiv (Ukraine)
  • O. V. Korobova Donetsk National Medical University, Ministry of Health of Ukraine; Kramatorsk (Ukraine)
  • A. P. Huk The State Institution "Romodanov Neurosurgery Institute, National Academy of Medical Sciences of Ukraine"; Kyiv (Ukraine)
  • V. M. Zhdanova The State Institution "Romodanov Neurosurgery Institute, National Academy of Medical Sciences of Ukraine"; Kyiv (Ukraine)
  • M. V. Kadzhaia The State Institution "Romodanov Neurosurgery Institute, National Academy of Medical Sciences of Ukraine"; Kyiv (Ukraine)

DOI:

https://doi.org/10.31288/oftalmolzh202165255

Keywords:

ocular motor abnormalities, the ocular motor, abducens, and trochlear nerves, causes, diplopia

Abstract

The paper presents anatomical features of ocular motor nerves (cranial nerves III, IV, and VI). Vascular abnormalities are major causes of ocular motor abnormalities and include microvascular lesions, aneurysms of brain vessels,  a pathology in the vertebrobasilar territory, brain neoplasms (particularly, those of the cerebellopontine angle, skull base and pituitary gland), and head trauma. Inflammation, myasthenia, endocrine ophthalmopathy, and demyelination are minor causes of ocular motor abnormalities. Ocular motor abnormalities should be differentiated from ocular motor lesions at the level of the medial longitudinal bundle such as internuclear ophthalmoplegia.

References

1.Zhdanova VN. [Ocular motor disorders in neurosurgical patients]. Neurokhirurgiia i nevrologiia Kazakhstana.2014; 2(35):3-9. Russian.

2.Zadoyannyi LV. [Analysis of the results of examination and treatment of patients with ocular motor disorders]. Ukrainskyi nevrologichnyi zhurnal. 2010; 2(15):72-7. Ukrainian.

3.Nikiforov AS, Guseva MR. [Neuroophthalmology: a guide]. Moscow: GEOTAR-Media;2008. Russian.

4.Duus P. [Topical diagnostics in neurology: Anatomy. Physiology. Clinical features]. Moscow: Vazar-ferro;1997. Russian.

5.Serova NK, editor. [Clinical neuroophthalmology. Neurosurgical aspects]. Tver: Triada; 2011. Russian.

6.Yokosato S, Kikkava Y, Takeda R, Kurita H. Oculomotor Nerve Palsy in a Patient with a Ruptured Middle Cerebral Artery Aneurysm. J Med Invest. 2017;64(1.2):165-167. https://doi.org/10.2152/jmi.64.165

7.Choi KD, Choi SY, Kim JS, Choi JH, Yang THо, Oh SY. Acquired ocular motor nerve palsy in neurology clinics: a prospective multicenter study. J Clin Neurol. 2019;15: 221-7.https://doi.org/10.3988/jcn.2019.15.2.221

8.Fang C, Leavitt J, Hodge D, Holmes J. Incidence and etiologies of acquired third nerve palsy using a population-based method. JAMA Ophthalmol. 2017 Jan 1; 135 (1): 23-8.https://doi.org/10.1001/jamaophthalmol.2016.4456

9.Jacobson DM, McCanna T, Layde PM. Risk factors for ischemic ocular motor nerve palsies. Arch Ophthalmol. 1994 Jul; 112(1): 961-66.https://doi.org/10.1001/archopht.1994.01090190109029

10.Madgura A, Biousse V, Ying G, Prasad S. Isolated third, fourth and sixth cranial nerve palsies from presumed microvascular versus other causes: a prospective study. Ophthalmology. 2013 Nov;120(11):2264-9.https://doi.org/10.1016/j.ophtha.2013.04.009

11.Hoi CP, Chen YT, Fuh JL, Yang CP. Increased Risk of Stroke in Patients with Isolated Third, Fourth, or Sixth Cranial Nerve Palsies: A Nationwide Cohort Study. Cerebrovasc Dis. 2016;41(5-6):273-82.https://doi.org/10.1159/000444128

12.Nakagawa Y, Toda M, Shibao S, Yoshida K. Delayed and isolated ocular motor nerve palsy following minor head trauma. Surg Neurol Int. Surg Neurol Int. 2017 Feb 6;8:20.https://doi.org/10.4103/2152-7806.199556

13.Cui V, Kouliev T. Isolated ocular motor nerve palsy resulting from acute traumatic tentorial subdural hematoma. Open Access Emerg Med . 2016 Oct 31; 8: 97-101.https://doi.org/10.2147/OAEM.S117687

14.Kanazawa T, Hino U, Kuramae T, Shihara M. Idiopathic unilateral oculomotor nerve palsy: a case report. Heliyon. 2020 Dec 3;6(12):e05651.https://doi.org/10.1016/j.heliyon.2020.e05651

15.Park K.A, Min JH, Oh SY. Idiopathic third and sixth cranial nerve neuritis. Jpn J Ophthalmol. 2019 Jul;63(4):337-343.https://doi.org/10.1007/s10384-019-00666-7

16.Das S. Total ophthalmoplegia - a series of case reports. DJO. 2020;30: 67-71.https://doi.org/10.7869/djo.531

17.Park K, Oh SY, Min JH, Kim BJ. Cause of acquired onset of diplopia due to isolated third, fourth and sixth cranial nerve palsies in patient aged 20 to 50 years in Korea: a high resolution magnetic imaging study. J Neurol Sci. 2019 Dec 15;407:116546.https://doi.org/10.1016/j.jns.2019.116546

18.Pineles SL, Velez FG. Isolated ocular motor nerve palsies. J Binocul Vis Ocul Motil. Jul-Sep 2018;68(3):70-77.https://doi.org/10.1080/2576117X.2018.1481266

19.Chaudhry IA, Elkhamry SM, AL-Rashed W. Carotid cavernous fistula: ophthalmological implication. Middle East Afr J Ophthalmol. 2009;16 (20): 57-63.https://doi.org/10.4103/0974-9233.53862

20.Jung EH, Kim SJ, Lee JY, Cho BJ. The incidence and presumed aetiologies of fourth cranial nerve palsy in Korea: a 10-year nationwide cohort. Eye (Lond). 2021 Nov;35(11):3012-9.https://doi.org/10.1038/s41433-020-01374-0

21.NtY, Lyons CJ. Ocular motor Nerve Palsy in Childhood. Can J Ophthalmol. 2005 Oct;40(5):645-53.https://doi.org/10.1016/S0008-4182(05)80062-6

22.Khaleefah MM, Narayanan S, Al Daallal, HA, Jones CM. Isolated ocular motor nerve palsy as a manifestation of diffuse large B cell lymphoma: a case report. Oncol Lett. 2020 Dec;20(6):285.https://doi.org/10.3892/ol.2020.12147

23.Mahale R, Mehta A, Shankar A, Buddaraju KA. A surprising cause of isolated ocular motor nerve palsy with pupillomotor palsy. Ann Indian Acad Neurol. Ann Indian Acad Neurol. Jan-Mar 2016;19(1):159-60.https://doi.org/10.4103/0972-2327.173300

24.Nambula SR, Karanam SR, Vankireddy M. Idiopathic, isolated, recurrent, ipsilateral sixth nerve paresis in an older adult - a rare case report. DJO. 2020;30 (4):564-71.https://doi.org/10.7869/djo.547

25.Richards BW, Jones FR, Younge BR. Causes and prognosis in 4,278 cases of paralysis of the ocular motor, trochlear, and abducens cranial nerves. Am J Ophthalmol. 1992 May 15;113(5):489-96.https://doi.org/10.1016/S0002-9394(14)74718-X

26.El-Habashi N. An ocular infection model using suckling hamsters inoculated with equine herpevirus 9 (EHV-9): kinetics of the virus and time-course pathogenesis of EHV-9 induced encephalitis via the eye. Vet Pathol. 2013; 50 (1): 56-64.https://doi.org/10.1177/0300985812442691

27.Vasilyeva IG, Zhdanova VN, Chopic NG, Makarova TA, Halanta ES, Tsiubko OI. Cranial nerve III and/or VI function abnormalities associated with active herpesvirus infection: Clinical experience and literature review. Oftalmol Zh. 2019; 1:9-17.https://doi.org/10.31288/oftalmolzh20191916

28.Henderson AD, Miller NR. Carotid-cavernous fistula: current concepts in aetiology, investigation and management. Eye (Lond). 2018 Feb;32 (2):164-72.https://doi.org/10.1038/eye.2017.240

29.Tan A, Faroooqui S, Li X, Tan YL. Ocular manifestations and the clinical course of carotid cavernous sinus fistulas in Asian patients. Orbit. 2014 Feb;33 (1):45-51.https://doi.org/10.3109/01676830.2013.851253

30.Chen H, Wang X, Yao Shan. The aetiologies of unilateral ocular motor nerve palsy: a clinical analysis on 121 patients. Somatosens Mot Res. 2019 Jun;36(2):102-8.https://doi.org/10.1080/08990220.2019.1609438

Published

2025-09-19

How to Cite

[1]
Vasyuta, V.A. et al. 2025. Neuro-opthalmological aspect of ocular motor abnormalities. Journal of Ophthalmology (Ukraine). 6 (Sep. 2025), 52–55. DOI:https://doi.org/10.31288/oftalmolzh202165255.

Similar Articles

You may also start an advanced similarity search for this article.