OPHTHALMOPLEGIA

ZALDI Z

FAKULTAS KEDOKTERAN
UNIVERSITAS MUHAMMADIYAH SUMATERA UTARA
MEDAN
2023

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 NEUROOPHTHALMOLOGY

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 OPHTHALMOPLEGIA

Ophthalmoplegia is characterized by paralysis or weakness

in one or more eye muscles. The condition may affect any of
the six and one external eye muscles that control eye
movement and eyelid or the three internal eye muscles that
control pupil size and help the eye focus.

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 TYPES OF OPHTHALMOPLEGIA
 Which eye muscles are being affected (internal vs. external ophthalmoplegia)

 What part of the brain is having problems sending signals to the eye muscles
(supranuclear vs. internuclear ophthalmoplegia)

 Whether the condition is chronic or progressive (chronic ophthalmoplegia or

progressive ophthalmoplegia)

 If the condition affects one or both eyes (unilateral vs. bilateral ophthalmoplegia)

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 CAUSES OF OPHTHALMOPLEGIA
 Brain tumors

 Gene mutations

 Head injury

 Diabetes

 Infections that affect the central nervous system

 Stroke

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 SIGNS AND SYMPTOMS
 Blurry vision

 Strabismus (misalignment of one or both eyes)

 Diplopia (double vision)

 Difficulty moving one or both eyes a certain way

 Difficulty swallowing

 Ptosis (droopy eyelid/s)

 General muscle weakness

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 EXTERNAL AND INTERNAL OPHTHALMOPLEGIA

External ophthalmoplegia is a paralysis or weakness in one of six

external muscles that work together to move the eye. These muscles
allow the eye to move up, down, side to side and to roll in a circle or
weakness of levator palpebral muscle (ptosis)

Internal ophthalmoplegia is a paralysis or weakness in one of three

internal muscles that help the eye to focus and control pupil size.

Total ophthalmoplegia = External + Internal ophthalmoplegia

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 EXTRAOCULAR MUSCLES

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 NERVE SUPPLY OF EXTRAOCULAR MUSCLES
Cranial nerve Muscle
Superior rectus muscle, Inferior, rectus muscle
Medial rectus muscle
Oculomotor nerve Inferior oblique muscle
(N. III)
Levator palpebrae superioris muscle

Trochlear nerve Superior oblique muscle

(N. IV)

Abducens nerve
Lateral rectus muscle
(N. VI)

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 EYE MOVEMENT

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 EXTERNAL OPHTHALMOPLEGIA
( STRABISMUS OR PTOSIS )

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 INTRAOCULAR MUSCLES

This type may affect any of these three internal muscles (intraocular muscles) of the
eye:

1. Ciliary muscle – ring of muscle that controls the shape of the lens to allow the
eye to focus on nearby or faraway objects

2. Dilator pupillae – muscle that increases the size of the pupil to allow in more light

3. Sphincter pupillae – muscle that reduces the size of the pupil to allow in less light

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 INTERNAL OPHTHALMOPLEGIA

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 TREATMENT FOR OPHTHALMOPLEGIA
Treatment and therapies for ophthalmoplegia can vary greatly depending on
the age of the patient, the type of ophthalmoplegia and cause of the
condition.

Children or adults who have double vision from ophthalmoplegia may get an
eye patch or special glasses.

Some patients may benefit from surgery to correct a specific issue; these
procedures include ptosis surgery or strabismus surgery..

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 REFERENCES

American Academy of Ophthalmology , Basic and Clinical Science Course, Section 5 :

Neuro-ophthalmology, 2021
Vaughan, D.G, Asbury, T.,Riordan-Eva, P. 19 th ed., General Ophthalmology, Mc.
Graw Hill Education , New York , 2018

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 Segala puji bagi Allah, Tuhan semesta alam.

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