Cause | Common Features* | Diagnostic Approach |
---|---|---|
Disorders that affect control of eye muscles by the nervous system† | ||
Certain strokes Overview of Stroke A stroke occurs when an artery to the brain becomes blocked or ruptures, resulting in death of an area of brain tissue due to loss of its blood supply (cerebral infarction). Symptoms occur suddenly... read more or transient ischemic attacks Transient Ischemic Attacks (TIAs) A transient ischemic attack (TIA) is a disturbance in brain function that typically lasts less than 1 hour and results from a temporary blockage of the brain’s blood supply. The cause and symptoms... read more | Often in older adults and in people with risk factors for these disorders (such as high blood pressure, atherosclerosis, and diabetes) Sometimes slurred speech, weakness, and/or difficulty walking | A doctor's examination MRI or CT of the brain |
A mass that presses on a nerve, such as a bulge in an artery ( brain aneurysm Brain Aneurysms An aneurysm is a bulge (dilation) in the wall of an artery. Aneurysms that occur in the arteries of the brain (cerebral arteries) are called cerebral aneurysms. Aneurysms may occur in any artery... read more ) or a tumor | Often pain (sudden if caused by an aneurysm) and often other symptoms of nervous system dysfunction (such as muscle weakness, loss of coordination, and abnormal sensations in the skin) | MRI or CT of the brain |
Inflammation or infection of the eye or surrounding structures (for example, abscess, sinusitis, and, rarely, with a blood clot in the cavernous sinus at the base of the skull) | Constant pain Sometimes fever, chills, fatigue, loss of sensation in the face, and/or bulging eyes | CT or MRI of the orbits and sometimes the brain |
Usually periods of relatively good health alternating with episodes of worsening symptoms Weakness that comes and goes from day to day Abnormal sensations such as tingling, numbness, pain, burning, and itching Clumsiness Loss of strength or dexterity in a leg or hand, which may become stiff As the disorder progresses, shakiness, partial or complete paralysis, and involuntary muscle contractions (spasticity), sometimes causing painful cramps Slowed, slurred speech Problems with urination and/or bowel function | MRI of the brain and spinal cord | |
Double vision that comes and goes Difficulty speaking or swallowing Weakness Muscles that weaken when they are used repeatedly | A doctor's examination Antibody testing, electrical testing of muscles, or both | |
History of long-term alcohol use Alcohol Use Alcohol (ethanol) is a depressant (it slows down brain and nervous system functioning). Consuming large amounts rapidly or regularly can cause health problems, including organ damage, coma,... read more Clumsiness, poor coordination, and confusion | A doctor's examination | |
Disorders that block eye motion | ||
Graves disease Causes (thickening of muscles and tissues around the eye—called infiltrative ophthalmopathy—that occurs most often in people who also have an overactive thyroid gland and rarely occurs in people with a normal thyroid gland) | Bulging of the eyes, often eye pain or irritation, watering, sensitivity to light, an enlarged thyroid gland (goiter), and thickened skin on the shins | Blood tests to evaluate thyroid function |
Injury, such as a fracture of the eye socket (orbit) or a collection of blood (hematoma) | Pain In people who have obviously had a recent eye injury | CT or MRI of the orbit |
Tumors (near the base of the skull, the sinuses, or the eye socket, called orbital tumors Tumors of the Orbit Rarely, tumors, either cancerous (malignant) or noncancerous (benign), occur in the tissues behind the eye. (See also Introduction to Eye Socket Disorders.) Tumors can form within the tissues... read more ) | Often pain unrelated to eye movement, bulging of one eye, and sometimes other symptoms of nervous system dysfunction | MRI or CT of the orbit and sometimes the brain |
* Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present. † Whether pain is present varies by cause. CT = computed tomography; ECG = electrocardiography; MRI = magnetic resonance imaging. |