Clinical Evaluation, Prevalence and Etiologic Factors in Patients with Ophthalmoplegia

Purpose: Ophthalmoplegia makes many physicians to refer the patients to neurologists and/or ophthalmologists for neuro-ophthalmic evaluation. Ophthalmoplegia has different etiologies some of which may be very harmful and need urgent intervention. Prevalence of the disease is not obvious. This study is designed to evaluate the various etiologies and their prevalence in this disorder. Methods: This descriptive case series study was conducted on 226 patients with ophthalmoplegia referred to adult neurology clinic between the years 2005 to 2009. An informed consent was taken, considering inclusion and exclusion criteria. All patients had a complete neurologic and ophthalmologic examination. Case based laboratory and imaging techniques were used to determine the etiology of the ophthalmoplegia. Data were analyzed by χ2 test. P<0.05 was considered significant. Results: Totally 226 patients were enrolled, including 121 (53.5%) males and 105 (46.5%) females (P>0.05). The age range was between 19-72 years (mean 56.2±11.2). Symptoms were unilateral in 215 (95%) patients. Most common etiologies were diabetes mellitus (16.8%), infectious disorders (14.6%), intracranial tumors (13.2%) and head trauma (11.1%). Other common etiologies were orbital tumors (7.1%), posterior communicating artery (PCA) aneurysm (5.3%), and orbital pseudo tumors (4.0%). The etiologic factors were not identified in 4% of cases. Conclusion: Ophthalmoplegia has many different etiologies some of which such as aneurysms can be potentially very dangerous and need careful and urgent management, while some others can be easily treated. Management is very important and warrants the cooperation and intervention of ophthalmologists and neurologists simultaneously.