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Iris -  INTERNAL OPHTHALMOPLEGIA Lecture 18 of 18  NEXT»

Internal ophthalmoplegia is characterized by paresis of ciliary body with loss of power of accommodation and pupil dilatation because of lesions of ciliary ganglion.

1. Acute porphyria-frequently bilateral
*2. Adie syndrome (myotonic pupil)
3. Aneurysm of the posterior communicating artery at its junction with the internal carotid-unilateral
4. Congenital-rare
*5. Cycloplegic ocular medication-most common
6. During acute illness-transient
7. During blepharoplasty-transient
8. Fisher syndrome (ophthalmoplegia-ataxia-areflexia syndrome)
9. Foramen lacerum syndrome (aneurysm of internal carotid artery)
10. Histiocytosis X (Hand-Schüller-Christian syndrome)
11. Hollenhorst syndrome (chorioretinal infarction syndrome)
*12. Increased intracranial pressure
13. Infections, including chickenpox, measles, diphtheria, syphilis, scarlet fever, pertussis, smallpox, influenza, herpes zoster, botulism, sinusitis, and viral hepatitis
14. Lubarsch-Pick syndrome (amyloidosis)
15. May be early lesion of acute or chronic ophthalmoplegia
16. Metastatic tumors of choroid
17. Nasopharyngeal carcinoma-early
18. Nothnagel syndrome (ophthalmoplegia-cerebellar ataxia syndrome)
19. Partial seizures
20. Retrobulbar injections of alcohol
21. Transscleral diathermy
22. Trauma to eye or orbit
23. Vogt-Koyanagi-Harada syndrome (uveitis-vitiligo-alopecia-poliosis syndrome)

Perlman JP, Conn H. Transient internal ophthalmoplegia during blepharoplasty: a report of three cases. Ophthal Plast Reconstr Surg 1991;7:141-143.

Rosenberg ML, Jabbari B. Miosis and internal ophthalmoplegia as a manifestation of partial seizures. Neurology 1991; 41:737-739.

Roy FH. Ocular syndromes and systemic diseases, 3rd ed. Philadelphia: Lippincott Williams & Wilkins, 2002.


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