Ophthalmoplegia (eye muscle weakness)

Eyes | Ophthalmology | Ophthalmoplegia (eye muscle weakness) (Disease)


Ophthalmoplegia (eye muscle weakness) is a paralysis or weakness of one or more of the muscles that control eye movement.

Because the eyes do not move together in ophthalmoplegia, patients may complain of double vision. Double vision is especially troublesome if the ophthalmoplegia comes on suddenly or affects each eye differently. Because ophthalmoplegia is caused by another, underlying disease, it is often associated with other neurologic symptoms, including limb weakness, lack of coordination, and numbness.

Causes and Risk factors

The condition can be caused by any of several neurologic disorders. It may be myopathic, meaning that the muscles controlling eye movement are directly involved, or neurogenic, meaning that the nerve pathways controlling eye muscles are affected.

Diseases associated with ophthalmoplegia are ocular myopathy, which affects muscles, and internuclear ophthalmoplegia, a disorder caused by multiple sclerosis, a disease which affects nerves.

When ophthalmoplegia is caused by muscle degeneration (myopathic), muscle biopsy, in which a small piece of muscle is surgically removed and examined microscopically, will find characteristic abnormal muscle fibers called ragged red fibers. In this form of ophthalmoplegia, the patient may experience weakness of the face, the muscles involved in swallowing, the neck, or the limbs.

Progressive external ophthalmoplegia is sometimes associated with specific neurologic syndromes. These syndromes include familial forms of spastic paraplegia, spinocerebellar disorders, or sensorimotor peripheral neuropathy.

Kearns-Sayre syndrome causes ophthalmoplegia along with loss of pigment in the retina, the light-sensitive membrane lining the eye. In addition, the disease may cause heart block that must be corrected with a pacemaker.

Diagnosis and Treatment

A CT scan and/or MRI will be done to identify the cause of the disorder. Tests to rule out other causes may be performed.

There is currently no defined treatment to ameliorate the muscle weakness of CPEO. Treatments used to treat other pathologies causing ophthalmoplegia has not been shown to be effective. ...