Diabetic third nerve palsy; Pupil-sparing third cranial nerve palsy
Cranial mononeuropathy III - diabetic type is a mononeuropathy, which means that only one nerve is damaged. It involves the third cranial (oculomotor) nerve, which is one of the cranial nerves that controls eye movement. This type of damage usually occurs with diabetic neuropathy.
Cranial mononeuropathy III is the most common cranial nerve disorder in people with diabetes.
Double vision that comes on quickly
- Drooping of one eyelid
- Pain in head or behind eye
An examination of the eyes will determine whether only the third nerve is affected or if other nerves have also been damaged. Signs may include:
- Eyes that are not aligned (dysconjugate gaze)
- Normal or abnormal pupil reaction
In some cases, it may not be clear if the nerve damage is due to diabetes or some other cause, such as an aneurysm. Tests to rule out other causes may include:
Many patients get better over time, although some have permanent eye muscle weakness.
Call your health care provider if you have double vision and it doesn't go away in a few minutes, especially if you also have eyelid drooping.
- Permanent eyelid drooping
- Permanent vision changes
There is no specific treatment to correct the nerve injury.
Treatments may include:
- Close control of blood sugar levels
- Eye patch or prisms to reduce double vision
- Pain medications (analgesics)
- Surgery to correct eyelid drooping or eyes that are not aligned
Some people may recover without treatment.
Control of blood sugar levels in people with diabetes may reduce the risk of developing this disorder.
Review Date: 2/13/2008
Reviewed By: Luc Jasmin, MD, PhD, Departments of Anatomy & Neurological Surgery, University of California, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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