An observational study of ocular motor nerve palsies in diabetes mellitus.

INTRODUCTION & HISTORY: A perfect alignment between the motor system of two eyes is responsible for viewing an object as single. The extraocular muscles of both eyes work in co-ordination. When any one or more of these falter, it may manifest as double vision, drooping of eyelids, deviation of eyes or some times with pain. Patients may present to the ophthalmologist for one of these complaints, may be referred by another physician or be seen accidently while they come for a routine check up. This may be one of the first manifestation of a multisystem disease like diabetes mellitus. AIM OF THE STUDY: 1. To study the ocular motor nerve palsy pattern due to Diabetes Mellitus 2. To study the relationship of glycaemic control in ocular motor nerve palsies. 3. To study the association of diabetic retinopathy and nephropathy in case of ocular motor nerve palsies. 4. To study the recovery pattern. MATERIALS AND METHODS: The cases studied, included those patients with neurogenic ocular motor nerve palsies who presented to the Regional Institute of Ophthalmology and Govt. Ophthalmic Hospital. All age groups and both sexes were included. A complete ophthalmological workup was done. CONCLUSION: 1. The diabetic ocular motor nerve palsies occur in a wide range of age but are more common in the age group of 51 - 60 years. 2. Overall males were affected more than females except in third nerve palsy which showed a slight female preponderance. 3. Left eye involvement was common but was of no significance. 4. Sixth nerve palsy was more common than third nerve palsy. 5. Fourth nerve involvement in diabetes mellitus is comparatively rare & no patients were detected with IV nerve palsy. 6. There was no significant correlation between the level of glycaemic control and incidence of ocular motor nerve palsy though retinopathy and nephropathy were seen to occur more with poorer glycaemic status. 7. More than three fourth of the patients had complete or partial recovery. 8. A careful history, general and complete ophthalmological workup with necessary basic investigations is enough to diagnose patients with diabetic ocular motor nerve palsies. Further evaluation and specialist opinion are necessary when there is deviation from the normal pattern of recovery