ABSTRACT
Introduction/objective To perform a cross sectional study of cases of ocular motility disorders due to brainstem vascular pathology. To review the types of ocular motility disorders documented in these cases and address the natural history of recovery.
Methods Each patient underwent a full Orthoptic and Ophthalmic examination. Complete neurological workup with appropriate CT/MR brain imaging was obtained. Patients with other brainstem pathology such as multiple sclerosis, degenerative or space occupying lesions were excluded.
Results A variety of ocular motility disorders were documented. These included cranial nerve palsies, ophthalmoplegia, nystagmus and abnormalities of saccadic and smooth pursuit movements. Treatment was mostly conservative with occlusion, filters and prisms and provision of support and coping strategies. Nine of the twelve patients were managed conservatively. Two of the nine patients had a return to normal ocular motility status within a 2-month period. Three patients required active intervention (Botulinum toxin (BT) or surgery) in addition to conservative treatment.
Conclusions: 16% (2/12 patients) improved to normal ocular motility status. This occurred within 2 months of initial insult. Eight other patients (67%) had a partial recovery with symptoms relieved either by conservative methods alone or by the addition of BT or surgery.
