This guideline last updated 07/05/2022 10:15:31
Ocular Motility
Third Nerve Palsy, Diplopia
Differential diagnosis
- Ptosis
- Involutional ptosis
- Strabismus
- Myasthenia gravis
- Thyroid eye disease
- Myositis
- Chronic progressive external ophthalmoparesis
Possible management by Optometrist
Treatment
- None
Advice
- Refer urgently to ophthalmology
Management Category
- Urgent referral to ophthalmology
Possible management by Ophthalmologist
- Urgent CT angiography to rule out posterior communicating artery aneurysm
- Address vascular risk factors for arteriosclerotic infarction of the vasa vasorum (microvascular blood supply) of the third nerve
- Smoking status
- Alcohol
- Diet
- Excercise
- Blood pressure
- Diabetes