ABSTRACT
Purpose: to evaluate the epidemiologic and etiologic characteristics of patients with paralytic strabismus at Labbafinejad Hospital during the years 2000-2001, Tehran-Iran
Method: as a descriptive study, consecutive cases with extraocular muscles paralysis [according to signs of cranial nerves 3,4, or 6 involvement and negative forced duction test] were enrolled in the study. Age, gender, duration of involvement, past medical history, intensity of muscle paralysis, deviometry, head posture, and etiology were evaluated
Results: of 119 patients [75 male and 44 female] with mean age of 30.58 +/- 22 years, 111 cases [%93.3] had unilateral involvement and 8 cases [%6.7] had bilateral involvement; 103 [%86.6] cases had isolated nerve involvement including sixth nerve paralysis [%33.6], fourth nerve paralysis [%32.7], and third nerve paralysis [%20.2]. The etiology was congenital in 32 patients [%26.9], vascular in 30 patients [%25.2], and traumatic in 27 patients [%22.7]. Mean age was 13.8 +/- 10.3, 56.4 +/- 122, and 27.4 +/- 15.6 in these subgroups, respectively. Other etiologies like unknown, infective, myasthenia gravis, migraine, multiple sclerosis, and tumoral followed in frequency. Over 60% of cases with 4th nerve palsy were operated, of which the most successful method was inferior oblique myectomy. Half of cases with 6th or 3rd nerve palsies were operated and the most common method was R and R
Conclusion: the most common nerve involvement was the 6th nerve. Fourth nerve involvement was the most common etiology in congenital disorders and 6th nerve involvement was the most common in traumatic and vascular disorders