Diagnosis of Paralytic Strabismus

• Published in: Neuro-Ophthalmology Japan Vol. 33; no. 1; pp. 3 - 10
• Main Author: Ueki, Satoshi
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Neuro-Ophthalmology Society 25.03.2016
• Subjects: abducens nerve palsy; cerebral aneurysm; intracranial tumor; oculomotor nerve palsy; trochlear nerve palsy
• ISSN: 0289-7024; 2188-2002
• DOI: 10.11476/shinkeiganka.33.3

This article is based on a lecture delivered at the 71st Japanese Association of Strabismus and Amblyopia held on July 3-4, 2015. Diagnosis of paralytic strabismus is almost equal to the diagnosis of isolated or combined ocular motor nerve palsies (oculomotor nerve palsy, trochlear nerve palsy, or abducens nerve palsy). In the process of diagnosis of ocular motor nerve palsies, clinicians should reveal cause of those. In order to achieve the mission, clinicians should know the age-specific prevalences of underlying causes of ocular motor nerve palsies and the anatomical characteristics of respective ocular motor nerves. It is crucial to consider cerebral aneurysm as a cause of oculomotor nerve palsy and intracranial tumor as a cause of abducens nerve palsy. The main purpose of this article is to address basic matters such as those mentioned above. Furthermore, this article describes advanced conditions, including pupil sparing oculomotor nerve palsy due to cerebral aneurysm, bilateral trochlear nerve palsies, acquired comitant esotropia indistinguishable from mild abducens nerve palsy, and carotid cavernous fistula as an cause of combined ocular motor nerve palsies.