Podcast #111: Diplopia

See fingersRun Time: 3 minutes

Author:  Eric Miller M.D.

Educational Pearls:

  • 6th nerve ocular palsy often presents with diplopia or double-vision. On examination, the pupils are normal and vision is normal, but one eye usually cannot move laterally.
  • There are three nerves that move the eye. The most important is the 3rd cranial nerve that moves the eye upward, medially and moves the eyelid. Second, is the 4th cranial nerve that moves the eye down and outward. Last is the 6th cranial nerve, or the abducens nerve, which moves the eye laterally. The 2nd cranial nerve or optic nerve gives the eye vision.
  • A 6th nerve palsy is not very serious but very common, usually caused by a neuropathy due to diabetes or hypertension. A 3rd nerve palsy is a more serious matter, usually indicating a CTA to rule out dissection as well as a neurologic consultation. A 4th nerve palsy is a very rare condition.
  • 80% of 6th nerve palsies improve on their own and are not associated with serious pathology. There is a small percentage that become worse and are often associated with aneurysm or arteritis.

Link to Podcast:  http://medicalminute.madewithopinion.com/diplopia/

References: http://www.ncbi.nlm.nih.gov/books/NBK217/

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