Clinical Characteristics and Course in Divergence Paralysis.

Lee, Haeng Jin; Shin, Yong Il; Lee, Yeon Hee

doi:2014.55.12.1878

J Korean Ophthalmol Soc > Volume 55(12); 2014 > Article

Original Article

Journal of the Korean Ophthalmological Society 2014;55(12):1878-1882.
DOI: https://doi.org/10.3341/jkos.2014.55.12.1878 Published online December 15, 2014.

Clinical Characteristics and Course in Divergence Paralysis.

Haeng Jin Lee, Yong Il Shin, Yeon Hee Lee

Department of Ophthalmology, Chungnam National University School of Medicine, Daejeon, Korea. opticalyh@hanmail.net

눈벌림 마비의 임상 양상 및 경과

이행진⋅신용일⋅이연희

Department of Ophthalmology, Chungnam National University School of Medicine, Daejeon, Korea

Abstract

PURPOSE
To improve the understanding of divergence paralysis by identifying its clinical characteristics. METHODS: We performed a retrospective chart review analysis of patients diagnosed with divergence paralysis that were followed up for at least 6 months. Clinical features, including disease onset, course, neurological examinations, and imaging studies were evaluated. RESULTS: Fifteen patients were included in the present study and the average age was 55.6 years. Thirteen patients had an acute onset and 2 had an insidious onset. The initial distance deviation ranged from 4 to 14 prism diopters (PD) of esotropia (mean, 8 PD esotropia) and near deviation ranged from 6 PD exophoria to 10 PD esophoria (mean, 1.2 PD esophoria). None of the patients developed additional neurological disorders associated with divergence paralysis during the follow-up period. Eleven of 13 patients with primary divergence paralysis continued to depend on the prism glasses with the same diopters. In the 2 patients with secondary divergence paralysis, distant diplopia disappeared as the underlying disease improved. CONCLUSIONS: In our study, the majority of divergence paralysis was not associated with neurological diseases and the patients had an acute onset. Primary divergence paralysis lasted for an extended period. However, secondary divergence paralysis was resolved quickly as the underlying disease improved.

Key Words: Divergence insufficiency;Divergence paralysis;Divergence weakness