Etiology and Course of Binocular Diplopia in Patients with Oculomotor Paresis or Paralysis

Abstract

Objective: To determine the etiology and evolution of binocular diplopia in patients with oculomotor paresis or paralysis.

Methods: A descriptive, longitudinal and prospective study was carried out, from May 2018 to June 2019, of a series of cases that were assisted in the consultation of the Pediatric Ophthalmology Service at Ramón Pando Ferrer Cuban Institute of Ophthalmology and met the inclusion criteria. The variables evaluated were age, sex, risk factors, etiology, treatment options and elimination of diplopia.

Results: The mean age of the studied sample was 56.8 years and the male sex predominated (56.7% versus 43.3%). The most frequent risk factor was microvascular (86.7%), fourteen patients with arterial hypertension and 12 with diabetes mellitus. Microvascular etiology also predominated in 18 patients out of 30. The medical treatment only solved 66.7% of the studied sample and 86.7% of cases eliminated diplopia in all diagnostic gaze positions.

Conclusions: The most frequently affected cranial nerve is the sixth and microvascular etiology prevailed in the sixth and third cranial nerves, however, for the fourth traumatic is the only cause found, which is consistent with the literature reviewed.