What are the other Names for this Condition? (Also known as/Synonyms)

• Acquired Cranial Nerve 3 Palsy
• Acquired Cranial Nerve III Palsy
• Acquired Third Cranial Nerve Palsy

What is Acquired Oculomotor Nerve Palsy? (Definition/Background Information)

• The oculomotor nerve (or cranial nerve III) is responsible for eye muscle and eyelid movement, including pupil response to light. The nerve originates from/near the brainstem and travels to the eye socket
• Any injury/damage to the oculomotor nerve can result in a set of associated signs and symptoms, and this is referred to as oculomotor nerve palsy. High blood pressure and uncontrolled diabetes form the most common cause of Acquired Oculomotor Nerve Palsy
• The condition may cause bulging of the eye, reduced visual acuity, pupillary defects, besides partial or complete paralysis in cranial nerve III. The treatment of Acquired Oculomotor Nerve Palsy primarily involves managing the underlying disorder and treating the symptoms

Who gets Acquired Oculomotor Nerve Palsy? (Age and Sex Distribution)

• Individuals in any age category may be affected by Acquired Oculomotor Nerve Palsy; however, a majority of the cases are present in adults
• Both males and females may be affected
• Worldwide, individuals of all races and ethnicity are prone to developing the condition

What are the Risk Factors for Acquired Oculomotor Nerve Palsy? (Predisposing Factors)

The risk factors for Acquired Oculomotor Nerve Palsy may include:

• Hypertension or high blood pressure
• Uncontrolled diabetes, especially type 1 diabetes
• Trauma to the oculomotor nerve (injury to the eye)
• Benign and malignant tumors involving the oculomotor nerve
• Chemotherapy
• Vasculitis or inflammation of the blood vessels
• Bulging of the blood vessels resulting in aneurysm around the eye region
• Infections

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Acquired Oculomotor Nerve Palsy? (Etiology)

• Acquired Oculomotor Nerve Palsy develops due to an injury or trauma to the oculomotor nerve, which is the third cranial nerve
• This can be caused by a variety of factors including tumors, hypertension, diabetes mellitus, tumors in the region, vasculitis, and external (head) injury

Sometimes, the exact cause of Acquired Oculomotor Nerve Palsy may not be well-established (idiopathic Oculomotor Nerve Palsy).

What are the Signs and Symptoms of Acquired Oculomotor Nerve Palsy?

The signs and symptoms of Acquired Oculomotor Nerve Palsy may differ from one individual to another. It may be mild or severe, depending on several factors. In general, the signs and symptoms include:

• Bulging of the eye, out of the orbit (exophthalmos)
• Drooping of the upper eyelid (ptosis)
• Double vision (diplopia)
• Impaired pupillary reflex, or a lack of pupil control
• Improper eye alignment or coordination (strabismus)
• Headaches
• Blurred vision
• Eye pain
• Swollen conjunctiva (chemosis)

Associated signs and symptoms of the underlying condition/disorder may also be observed.

How is Acquired Oculomotor Nerve Palsy Diagnosed?

Acquired Oculomotor Nerve Palsy may be diagnosed by the following observations and tests:

• Physical examination and medical history evaluation
• Assessment of signs and symptoms
• General eye exam
• Fundoscopic (ophthalmoscopic) examination by an eye specialist, who examines the back part of the eye (or the fundus)
• Visual acuity test using a special and standardized test chart (Snellen chart)
• Slit-lamp examination
• Visual evoked potential (VEP) test
• Cranial nerve examination
• Neurological, motor skills, and cognitive assessment
• Imaging studies including CT and MRI scans of the head and neck region, if needed

Additional tests and procedures to diagnose the underlying causative condition may be needed.

A differential diagnosis to eliminate other conditions/disorders may be considered, before arriving at a definitive diagnosis. These may include:

• Chronic progressive external ophthalmoplegia (CPEO)
• Giant cell arteritis (GCA)
• Internuclear ophthalmoplegia
• Myasthenia gravis
• Orbital pseudotumor
• Thyroid-associated orbitopathy

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Acquired Oculomotor Nerve Palsy?

The complications of Acquired Oculomotor Nerve Palsy may include:

• Permanent damage to the oculomotor nerve or other involved cranial nerves
• Facial paralysis
• Altered mental status
• Unsteady gait, walking difficulties
• Decreased quality of life
• Treatment related complications

Complications arising from the underlying/associated condition, if any, may be noted.

How is Acquired Oculomotor Nerve Palsy Treated?

The treatment of Acquired Oculomotor Nerve Palsy depends on the severity of the condition, the presenting signs and symptoms, the underlying causative factor, and overall health status of the individual.

• The treatment measures include treating the symptoms and managing the underlying condition/disorder
• Both non-surgical and surgical intervention measures may be considered; in many cases, surgery forms the mainstay of treatment

How can Acquired Oculomotor Nerve Palsy be Prevented?

Some forms of Acquired Oculomotor Nerve Palsy may be preventable, such as those caused by hypertension, diabetes, and infections. It may be difficult to prevent the condition if it is caused by brain tumors, vasculitis, and aneurysms.

The following steps may be taken to lower one’s risk for Acquired Oculomotor Nerve Palsy:

• Lead a healthy and stress-free life
• If obese or overweight, try to reduce weight through proper diet and exercise
• Avoid drinking and smoking
• Treat infections and other disorders early and adequately

What is the Prognosis of Acquired Oculomotor Nerve Palsy? (Outcomes/Resolutions)

The overall prognosis of Acquired Oculomotor Nerve Palsy depends on the severity of the condition, the underlying causative factor, and overall health status of the individual. The prognosis may vary from one individual to another.

Additional and Relevant Useful Information for Acquired Oculomotor Nerve Palsy:

Please visit our Eye & Vision Health Center for more physician-approved health information:

https://www.dovemed.com/health-topics/vision-center/