Ocular motor mononeuropathies in diabetes mellitus: A brief review.

Abstract

Ocular motor mononeuropathies affect cranial nerves III, IV and VI and are more frequent in diabetes mellitus, with oculomotor nerve involvement being predominant. The aim of this narrative brief review was to discuss the clinical manifestations, diagnosis and management of ocular motor nerve palsies in subjects with diabetes. Clinical manifestations often include ptosis, diplopia, and periorbital pain. A characteristic of third nerve palsy is pupillary sparing. Differential diagnosis may be challenging due to overlapping symptoms with nerve palsies of other aetiologies. Treatment includes optimised glycaemic control and management of vascular risk factors. Neuroprotective agents, mainly alpha-lipoic acid and botulinum toxin A have been occasionally used, as well. Spontaneous recovery is also seen in many cases.