THE SIZE and reactivity of the ipsilateral pupil is generally considered a useful guide to help clinicians distinguish oculomotor nerve injury caused by aneurysmal compression from peripheral nerve infarction. Some characteristics of the internal ophthalmoplegia may help to distinguish diabetic ophthalmoplegia from injury of the oculomotor nerve caused by aneurysmal compression. None of the patients had a fully dilated unreactive pupil.Ĭonclusions Pupil involvement in patients with diabetes-associated oculomotor nerve palsy occurs more often than has been previously recognized, although the degree of anisocoria in any 1 patient is usually only 1 mm or less. The size of the anisocoria was 1 mm or less in most patients. Results Internal ophthalmoplegia occurred in 10 (38%) of 26 patients. Descriptive statistics were used to identify the frequency and characteristics of pupil involvement. The degree of anisocoria, if present, was recorded at each office visit until the ophthalmoplegia had resolved. A pupil ruler accurate to within 0.5 mm was used to measure pupil diameters using a standardized procedure. Patients and Methods In this prospective study, standardized enrollment criteria were employed to identify 26 consecutive patients with diabetes-associated oculomotor nerve palsy who were evaluated in a referral-based, outpatient neuro-ophthalmology practice. Objective To derive a reliable estimate of the frequency of pupil involvement in patients with diabetes-associated oculomotor nerve palsy. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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