A Comprehensive Review on Oculomotor Nerve Palsy: Diagnosis and Management Strategies

Yasir Adil Shakor; Raheleh Moravvej; Ali Majdi; Razieh Bahreini

doi:10.18502/jmr.v19i2.18345

Yasir Adil Shakor Azadi Teaching Hospital, Kirkuk, Iraq.
Raheleh Moravvej Department of Optometry, School of Rehabilitation Sciences, Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran.
Ali Majdi Department of Optical Techniques, College of Health and Medical Techniques, Al-Mustaqbal University, Babylon, Iraq.
Razieh Bahreini Department of Vision Science, Pacific University College of Optometry, Forest Grove, United States.

DOI: https://doi.org/10.18502/jmr.v19i2.18345

Keywords: Third nerve palsy; Oculomotor nerve palsy; Strabismus; Blepharoptosis

Abstract

The third cranial nerve (oculomotor nerve) plays an essential role in the function of ocular movement and mainly innervates the inferior oblique, medial rectus, inferior rectus, superior rectus, levator palpebrae, pupillary sphincter, and ciliary muscle. The most frequent clinical manifestations of oculomotor nerve palsy are ophthalmoplegia, ptosis, pupillary dysfunction, and diplopia. The etiology of oculomotor nerve palsy is complex, including congenital tumors, craniocerebral trauma, intracranial inflammation, diabetes, intracranial aneurysm, cerebrovascular infarction or hemorrhagic disease, myasthenia gravis, multiple myeloma demyelinating diseases, and other uncommon causes. Each etiology of oculomotor nerve palsy has its corresponding clinical features. The present study comprehensively reviews the common etiologies of oculomotor nerve palsy and the corresponding clinical manifestations and treatment methods to help practitioners with the prompt and accurate clinical diagnosis of the causes and effective management plan.