The current cohort of 193/66 (34.2%) females and 127 (65.8%) males) patients with isolated paresis or paralysis of the muscles innervated by the cranial nerves III, IV or VI, correspond to 4.7% of the patients in Ocular Motility Section (Table 1).
The age of onset of the clinical manifestations of the group with paralytic strabismus or acquired paretic was between 1 and 85 years. The congenital cases were studied separately; 11/193 (5.7%) patients were congenital cases, and the remaining 182 (94.3%) were acquired paretic 31/193 (16.1%) constituted the pediatric age group.
The mean follow-up pf the patients was 203.30 days.
The right eye was involved in 82/193 (42.5%), the left eye in 73 (37.8%) and both eyes in 38 (19.7%) cases.
Our cohort included 2 cases of myasthenia gravis, suggesting myogenic cause.
Herein, strabismus esotropia was found in 127/193 (65.8%) cases (Table-). Also, 42/193 (21.8%) cases occurred due to trauma to the cranial nerve or extra ocular muscle.
Furthermore, cranial nerve VI was affected in 110/193 (56.9 48.7%) cases, of which 15 (13.6 %) were traumatic, and 95(86.3 %) were non-traumatic.
Cranial nerve III was affected in 47/193 (24.4%) cases, of which 16 (34%) were traumatic, and 31 (66%) were non-traumatic.
Among the other causes of cranial nerve III palsy, the infection of the central nervous system was detected in 1 case.
Concerning disease management, 149/193 (77.2%) received medical treatment, 29 (15%) received surgical management, and 7 (3.6%) were advised but did not undergo surgery. Moreover, 18 (9.3%) cases did not receive any treatment, while 7 (3.6%) were lost to follow-up. A significant difference was observed between first presentation and final visit (P=0.05)
In the current cohort, 43/193 (22.3%) exhibited traumatic aetiology, and no relevant cause was identified in 114/193 (59.1%) cases.
The comparison between the deviation in primary position at the time of presentation and the end revealed significant differences (p<001), but no difference was observed while comparing traumatic and non-traumatic cases (P=0.435).