J Korean Ophthalmol Soc.  2014 Dec;55(12):1878-1882. 10.3341/jkos.2014.55.12.1878.

Clinical Characteristics and Course in Divergence Paralysis

• Lee HJ
• Shin YI
• Lee YH

• KMID: 2338979
• DOI: http://doi.org/10.3341/jkos.2014.55.12.1878

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.

Keyword

Divergence insufficiency; Divergence paralysis; Divergence weakness

MeSH Terms

Diplopia
Esotropia
Exotropia
Eyeglasses
Follow-Up Studies
Glass
Humans
Nervous System Diseases
Neurologic Examination
Paralysis*
Retrospective Studies

Reference

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