Abnormal Eye Movements
Here is a summary of the findings and causes of abnormal eye movements. In each image, the right eye is always the abnormal one.
III nerve (oculomotor) palsy
- Description: affected eye lies ‘down and out’ with a dilated pupil
- Common causes: aneurysm, trauma, microvasculopathy, e.g. diabetes, atherosclerosis
IV nerve (trochlear) palsy
- Description: affected eye elevated on forward gaze, accentuated on head tilting to affected side
- Common causes: trauma, microvasculopathy
VI nerve (abducens) palsy
- Description: affected eye adducted at rest and no movement on lateral gaze
- Common causes: space occupying lesion, trauma, aneurysm
Internuclear ophthalmoplegia
- Description: one or both eyes fail to adduct
- Common cause: multiple sclerosis (lesion in medial longitudinal fasciculus)
