7.1 Cranial Nerve III (Oculomotor) Palsy
7.2 Cranial Nerve IV (Trochlear) Palsy
7.3 Cranial Nerve VI (Abducens) Palsy
7.4 Cranial Nerve VII (Facial) Palsy
7.5 Optic Nerve Function
7.6 Visual Fields to Confrontation
7.8 Horner’s Syndrome
7.10 Neuro-Ophthalmic Differential Diagnoses and Aetiologies
Cranial nerve VI palsies are extremely common in examinations. Although relatively simple to diagnose, it is important that the examiner look carefully for signs of associated cranial nerve palsies, Horner’s syndrome and papilloedema.
Ipsilateral CNVI, CNVII+
Contralateral hemiplegia (corticospinal tract)
Ipsilateral horizontal gaze palsy (PPRF), CNVII+
Contralateral hemiplegia (corticospinal tract), INO
HT, Cholesterol, DM, Smoking
Internal carotid artery aneurysm (cavernous sinus). Subarachnoid haemorrhage, carotico-cavernous fistula, cavernous sinus thrombosis, pituitary apoplexy
Treat the underlying cause (e.g. diabetes, hypertension).
Indications for treatment:
Nishida Y, Inatomi A, Aoki Y, et al. A muscle transposition procedure for abducens palsy, in which the halves of the vertical rectus muscle bellies are sutured onto the sclera. Jpn J Ophthalmol. 2003;47(3):281‐286. doi:10.1016 / s0021-5155(03)00021-2
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