What is ophthalmoplegia?
1. Internal ophthalmoplegia – occurs as a result of paralysis of sphincter pupillae and ciliaris muscles due to III rd nerve palsy. The pupil will be dilated and fixed, i.e. there will be absence of direct and consensual light reflex as well as the accommodation reflex. 2. External ophthalmoplegia – occurs due to IIIrd, IV th nerve palsy ; extraocular muscle paralysis due to myasthenia gravis, ocular myopathy and exophthalmos. 3. Internuclear opthalmoplegia – Lesion in the medial longitudinal bundle anywhere in between the midbrain and pons will produce difficulty in adduction in one eye and nystagumus in the abducting eye. Points to note during optic nerve examination : 1. Acuity of vision. 2. Field of vision 3. Colour vision and 4.
