Nerve Lesions Affecting Eye movement

Nerve Lesions Affecting Eye movement

·        Droopy lid (ptosis) and small pupil (Horner‟s syndrome) – due to lesions in the brain stem, in the apex of the lung, in the neck or on the carotid artery (eg carotid dissection)

·        Droopy eye lid and large pupil non reactive to light: 3^rd nerve palsy – eye turned down and out due to weakness of MR, SR, IO, and IR

·        Differential for Ptosis: idiopathic (esp elderly), myasthenia, muscular dystrophies, myotonic dystrophy

·        Nystagmus: if present in all directions will be central (commonest cause is antiepileptics)