Corneal diseases

Cornea - a front part of an external fibrous envelope of an eyeball; nonvascular, high-sensitivity, transparent, an optically homogeneous envelope with smooth, a smooth surface. Except for protective and basic function the cornea is the main refracting surface of optical system of an eye.

Diseases of a cornea makes about 25 % of the general number of diseases of eyes, and quite often are the reasons of blindness and lowering of vision.

Diseases of a cornea are rather various. Most often there are inflammatory diseases of a cornea (keratitis), differing greater variety of forms and being one of principal causes of decrease in sight and blindness, and also keratikonus. The Most frequent reasons of keratitis and keratoconjunctivitis are virus and bacterial infections.

Keratikonus - a condition of an eye at which the normal spherical form of a cornea is broken, the cornea is bent. On a surface of an eye the camber similar to a cone that leads to strong easing of sight develops.

Dystrophies and degenerations of a cornea happen primary and secondary. In a basis primary local and general infringements of a metabolism with adjournment in a cornea of products of a pathological exchange lay. Secondary dystrophies develop after transferred keratitis, traumas, burns of eyes.

For the prevention of heavy complications of diseases of a cornea are required: proper diagnostics, duly and active treatment. Various medicinal substances are applied to local treatment in the form of drops, injections. Methods of electrophoresis, phonophoresis, treatment by laser radiation are used also.

For carrying out of purposeful treatment bacterial keratitis definition of sensitivity of microflora to antibiotics by crop of defeat separated from the center is necessary.

Instruction to the patient after change of a cornea

To you the microsurgery of change of a cornea is lead. The thin seam keeping a donor fabric, can long-standing time (about one year) to remain in a cornea. It allows you to start to work with the moderate physical activity earlier. At the same time, it is necessary to remember the periodic medical control over a condition of a seam.
Durable healing of a wound after change of a cornea comes only in 6-10 months after operation. Therefore after an extract from a hospital it is necessary for you to continue the recommended treatment in house conditions. Instilling drops or loading ointments can be made the purest hands before a mirror or in a prone position, as well as by means of relatives, using those receptions with which you have got acquainted in a hospital.

During the first month to sleep it is necessary on a back or on the party opposite to the operated eye. The food can be usual, it is necessary to exclude alcoholic drinks. Surplus of sweets is not desirable. Easy gymnastic exercises without jumps, run and inclinations are useful. During rest and walks during the first year after operation it is necessary to avoid stay on the bright sun. It is impossible to sunbathe. It is possible to use the blacked out glasses. The replaced cornea during several months, and sometimes several years, has the lowered sensitivity. Therefore it is impossible to rub sharply an eye a scarf or a hand, it is necessary to be cautious at washing, to cover the operated eye during a strong wind and to avoid walks in frosty days even on the second or the next years after operation. It will help to save a cornea from damages and freezing injury.

You can watch TV, go to museums, cinema and theatre if it is not connected with difficult and close moving to transport. It is possible to start the usual or limited work in 2-4 months depending on a condition of the operated eye and working conditions. Expansion of the general mode should be carried out one step at a time, however during the first year work with a slope of a head downwards, outdoor games, run, heavy physical work is absolutely counter-indicative. After an output for work do not forget to show to the oculist each 2-3 months within the first year after operation, especially if it is not removed an encircling stitch.

In case of occurrence of reddening and an ache in an eye, and blear-eyedness to you it is necessary for photophobia to see a doctor promptly. Only early the begun treatment can prevent deterioration of vision.

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Factors and the conditions causing irritation of a dental pulp

The irritation of a pulp of a tooth can arise owing to caries of a teeth, as a result of preparation of a tooth and carious cavities, under influence a filler material, owing to penetration of microorganisms at not tight seal, at an exposure dentin.

Caries of a tooth serves as a principal cause of changes in a pulp and its inflammations. Already at initial damage dentin fibrilloblasts react adjournment secondary and formation of a layer scleroid dentin (adjournment of salts of calcium on walls of dentinal canaliculus) down to full occlusion of dentinal canaliculus. These processes should be considered as display of protective mechanisms of a pulp on action of a cue.

At processing of a caries and destruction of enamel of a bacterium get in dentin, however the inflammation of a pulp does not arise. It is established, that first signs of an inflammation come, when carious the cavity is separated from a pulp by a layer of 1,1 mm [Reeves R., Stanley H. R., 1996], i.e. the pulp practically is not infected up to an instant of penetration of microorganisms in secondary dentin [Massler, Pawlak J., 1977].

Preparation of a cavity without use of a water spray leads to its damage. Thus probability of damage of the in direct proportion area of preparation and depth of damage. Thus, preparation of a tooth under vinirs or artificial crownwork without due cooling serves a serious risk factor for a dental pulp.

Filler materials. There are the numerous data specifying irritating influence various of filler materials. From cements the most expressed adverse action renders silicate though specify, that it is shown at formation of a clearance between edge of enamel and dentin as microorganisms nestle close in dentin [Brannstrom, 1979].

Composites also are considered as irritating materials. First of all, toxicity of composites of the first generation was marked. Materials let out now as specify numerous supervision, render insignificant influence on a pulp.

During many years use of bondings was studied at sealing. It is proved, that improvement of a compounding bondings has allowed to achieve favorable reaction of a pulp to used composites.

Regional permeability as considers a number of researchers, is a principal cause of irritation of a pulp after sealing. The leading part thus belongs to microorganisms. With the purpose of the prevention of the specified changes in a pulp it is recommended to spend padding fabrics of a tooth and use bonding systems.

The exposure of dentin can occur after loss of a seal, as a result of deleting fabrics, at erosion, etc., that is accompanied by sensitivity action of irritating factors. Sensitivity can arise also at an exposure cervical dentin because canaliculus of dentin become opened.

The sheeting (direct) provides:

1) clarification of a surface of a pulp;

2) drying of a cavity;

3) imposing on the naked pulp of medical paste;

4) a seal from zinc oxide eugenic acid cement;

5) imposing of a constant seal.

Most widely used materials for protection of a pulp contain all calcium hydroxide. As a result of it above a site of an exposure it is postponed secondary dentin, forming the dentin bridge. Consider, that formation of a barrier occurs not due to the calcium containing in a material, closing a pulp.

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Hip Replacement Dislocation

Hip replacement surgery is very successful; pain relief and increased ability to perform routine activities are among the best benefits of this procedure. Unfortunately, hip replacements have some potential complications. These complications are uncommon, but they do occur--sometimes in unforeseen circumstances. Among the most frequently seen complications of hip replacement surgery is dislocation of the hip replacement. Hip replacement dislocations occur in about 4% of first-time surgeries, and about 15% of revision hip replacements.

How do hip replacements work?

Hip replacements are most commonly performed in patients with severe arthritis of the hip joint. The hip replacement uses a metal and plastic implant to replace the normal ball-and-socket hip joint. By removing the worn out bone and cartilage of the hip joint, and replacing these with metal and plastic, most patients find excellent pain relief and improved motion of the hip joint.

Why do hip replacement dislocations occur?

Normal hip joints have many surrounding structures that help to stabilize the hip joint. These structures include muscles, ligaments, and the normal bony structure of the hip joint. Together, these structures keep the ball (the femoral head) within the socket (the acetabulum). When the hip replacement surgery is performed, the hip becomes less stable. By loosing some of these hip stabilizers, the metal and plastic hip replacement is prone to "coming out of joint," or dislocating.

What happens when a hip replacement dislocation occurs?

Patients who have a hip replacement are instructed on hip precautions. Hip precautions are various maneuvers a patient who has undergone a hip replacement needs to avoid. Hip precautions include:

• Do not cross your legs
• Do not bend our legs up beyond 90 degrees
• Do not sit on sofas or in low chairs
• Do not sleep on your side

Most physicians ease these precautions after rehabilitation, but total hip replacements are less stable than normal hips even years after surgery.

These activities place the hip joint in a position where the ball may fall out of the socket. Sometimes hip replacements are more prone to hip dislocation. Factors that can contribute to hip replacement dislocations include:

• Malpositioning of the hip replacement implants
• Revision hip replacements
• Excessive alcohol intake
• Neuromuscular problems (e.g. Parkinsons disease)
• Developmental hip dysplasia

Sometimes patients have no identifiable cause for their sustaining a dislocation of their hip replacement.

What is the treatment of a hip replacement dislocation?

Hip replacement dislocation treatment depends on several factors. The first step is usually to reposition the hip joint. This procedure, called a reduction of the hip replacement, is performed under anesthesia--either light sedation in the emergency room, or general anesthesia in the operating room. During the procedure, your orthopedic surgeon will pull on the leg to reposition the hip within the socket.

Most often the hip "pops" back into position. X-rays will be obtained to ensure the hip is repositioned and to see if there is any identifiable reason for the dislocation. If multiple dislocations occur, surgery may be necessary to prevent further dislocations. The implants can be repositioned, or special implants can be used to try to prevent further dislocations. You will need to discuss with your orthopedic surgeon the cause of your dislocation, and what treatments are available for the problem.

_Sources:

_{Soong M, et al. "Dislocation After Total Hip Arthroplasty" J. Am. Acad. Ortho. Surg., September/October 2004; 12: 314 - 321.}

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Hernias at children: inguinal, umbilical, a hernia of a white line of a stomach. Symptoms. Methods of treatment.

Hernia is an outwandering bodies from a cavity in norm them borrowed through properly existing or pathologically generated aperture with conservation of an integrity of envelopes, their covering, or availability of conditions for this purpose.
Let's consider a hernia of a forward belly wall of a stomach. It is the most widespread surgical pathologies at children. An original cause of progress of hernias - defect of progress of a belly wall. However there are some features which we shall consider separately.

Umbilical hernia. For 4-5 day after a birth of the child the umbilical cord disappears. The umbilical ring consists of two parts. The bottom part where pass umbilical arteries and a uric channel, are well reduced and form a dense cicatricial fabric. In the top part there passes a umbilical vein. Its walls thin, have no muscular environment, are badly reduced in the further. Quite often at weak peritoneal band and patent to a umbilical vein the umbilical hernia is formed. Except for it the major factor promoting occurrence of this pathology, frequent increase of intrabelly pressure is. It can be caused, for example, frequent we cry the child.
The aperture in the top part of a umbilical ring can be wide, and not trouble the child. But in case of small defect with firm edges concern of the child probably. As a rule, a umbilical hernia always can be reduced. The restrained umbilical hernia to meet in an adult practice more often. However we quite often should operate children with unreducible hernias (when hernial contents are attached to an internal wall of a leather of a forward belly wall by solderings).

Experience of out-patient supervision of children with the umbilical hernias diagnosed at early age, allows to tell with confidence, that to 5-7 years age often there comes self-healing. Liquidation of a hernia is assisted with strengthening a belly wall. It certainly massage, laying of children on a tummy, gymnastics. Surgical treatment it is begun not earlier than 5 years age. Properly and accurately lead operation, allows to eliminate a hernia with good cosmetic effect. As a rule, relapses does not happen.

Hernia of "a white line" stomach (anteperitoneal adipoma). If to lead a line between omphalus and ensiform shoot of a brest is and there is "a white line" stomach. At a direct muscle of the stomach, shaping given area, is from 3-6 tendinous crosspieces. In seat of intersection of these crosspieces and "a white line" stomach sometimes there are small defects. In them it is often stuck out anteperitoneal fat. If they settle down in immediate proximity from a umbilical ring, them name paraumbilical (periomphalic) hernias. Unfortunately, these hernias are not inclined to spontaneous closing. Treatment only operative, similar to operation at a umbilical hernia.

An inguinal hernia. Very frequent surgical disease at children. As a rule, all hernias at children of early age congenital. What reasons of occurrence of this pathology? It is a lot of opinions in this occasion at children's surgeons. It and weakness of a forward belly wall and feature of a structure inguinal areas and nonclosure vaginal a shoot abdominal membrane and a heredity. We shall try under the order, on an example of an congenital inguinal at the boy.
About from 6-th month of intra-uterine progress of the boy orchis fall from a belly cavity in marsupium on inguinal to the channel. Therefore these hernias name slanting. For presentation present itself, that on a tube (vaginal to a shoot abdominal membrane) as on the lift, orchis, conducted by the lowering mechanism from a belly cavity goes down in marsupium. Then under the plan there is a closing a pipe (vaginal shoot abdominal membrane) and by that the termination of the message between belly completely and marsupium. If it does not occur, at increase of intrabelly pressure in the nonclosure vaginal shoot of abdominal membrane leaves contents of a belly cavity. It is an inguinal hernia.
What for to an organism to strain and stretch a stomach when there is an opportunity to dump a superfluous pressure in "hernial contents". And frequently the child grows and … increases hernial bulge. Treatment of the given pathology only operative. Technically to carry out it at the child easier is more senior 1 year. However quite often operation is shown to the child at once at statement of the diagnosis. To wait dangerously. Occurrence of terrible complication - infringement inguinal hernias is possible. Hernial bulge in inguinal areas earlier that arising disappearing suddenly became firm, the child has begun to worry and has begun to cry, there was a vomiting, refusal of meal. At touch up to firm "bulla" in a groin to the child it is very painfull!!!
Most likely, there was an infringement inguinal hernias. To not give food, not give water and it is urgent to bring the child to the hospital. Muscles of a stomach have restrained contents of a hernial bag. It can be a site of a gut, a bladder or ootheca at girls. If urgently to not help the child after a while the site, deprived blood supplies, can be sphacelous, i.e. become lifeless. In that case treatment very heavy and long. In my practice there were 2 cases, hernial contents at the restrained hernia were a site of a blind gut with again changed an appendicular shoot. It was necessary to lead simultaneously with celotomy.

Believe, it is better to not lead up to infringement. To operate the child with a hernia it is necessary healthy, with good analyses and in the daytime. And it is possible only at scheduled operation. Every year in our branch, about to 500 children with the given pathology, scheduled operative interventions are spent. Operations last about 15-20 minutes, pass under a mask narcosis and the control of skilled anaesthesiologists. And here, after the small period of rehabilitation - your child is completely healthy. We have made all in time and properly.

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Peptic Ulcers

Description An in-depth report on the causes, diagnosis, treatment, and prevention of stomach and GI ulcers.

Alternative Names Duodenal Ulcers; Gastric Ulcers; H. Pylori; Nonsteroidal Anti-inflammatory Drugs, or NSAIDs

Causes Before the discovery of the bacterium Helicobacter (H.) pylori, the stomach was believed to be a sterile environment. Now, H. pylori is known to be a major cause of peptic ulcers. The bacteria appears to trigger ulcers in the following way: H. pylori's corkscrew shape enables it to penetrate the mucous layer of the stomach or duodenum so that it can attach itself to the lining. It survives its highly acidic environment by producing urease, an enzyme that generates ammonia and neutralizes the acid. H. pylori then produces a number of toxins and factors that in certain individuals cause inflammation and damage to the lining, leading to ulcers. It also alters certain immune factors that allow it to evade detection and cause persistent inflammation for a person's lifetime--even without invading the mucous membrane.

Even if ulcers do not develop, the bacterium is now considered to be a major cause of active chronic inflammation in the stomach (gastritis) and in the upper part of the small intestine (duodenitis).

It is also strongly linked to stomach (gastric) cancer and possibly other non-intestinal problems.

Factors That Trigger Ulcers in H. pylori Carriers. It should be noted that H. pylori is found in about 25% of people who do not have peptic ulcers. The magnitude of H. pylori infection, particularly in older people, may not always predict the presence or absence of peptic ulcers. Other variables, then, need to be present to actually trigger ulcers. They may include the following:

• Genetic Factors. Some people harbor genetic strains of H. pylori that may make the bacteria more dangerous and increase the risk for ulcers in infected individuals. The most intensively investigated genetic factor is cytotoxin-associated gene A (CagA), which has been associated with both gastric and duodenal ulcers as will as with stomach cancer. Other genetic types that may also increase bacterial severity are called vacuolating cytotoxin (vacA) and antigen-binding adhesin (BabA) genotypes. Some of these genetic factors may be more or less important for development of ulcers depending on ethnicity.
• Immune Abnormalities. Some experts suggest that certain individuals have abnormalities in the immune response in the intestine that allow the bacteria to become injurious to the lining.
• Lifestyle Factors. Although lifestyle factors (e.g., chronic stress, coffee-drinking, smoking) were long believed to be the primary cause of ulcers, it is now thought they only increase susceptibility to them in some H. pylori carriers.

When H. pylori was first identified as the major cause of peptic ulcers, it was found in 90% of people with duodenal ulcers and in about 80% of people with gastric ulcers. As more people are being tested and treated for the bacteria, however, the rate of H. pylori associated ulcers has declined. For example, a 2001 study suggested that about half of ulcers are not caused by H. pylori. Instead, they tend to be due to regular use of nonsteroidal anti-inflammatory drugs (NSAIDs), which include aspirin and other common pain relievers. Genetic factors, or, rarely, Crohn's disease or Zollinger-Ellison syndrome also cause ulcers.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) is the second most common cause of ulcers and the rate of NSAID-caused ulcers is increasing. About 20 million people take prescription NSAIDs regularly, and over 25 billion tablets of over-the-counter brands are sold each year in America. The most common NSAIDs are aspirin, ibuprofen (Advil), and naproxen (Aleve, Naprosyn), although many others are available.

Their damaging effects appears to rest primarily on actions that block an enzyme called cyclooxygenase (COX), which is involved in the production of prostaglandins. The COX enzyme has two forms:

• COX-2 causes intestinal contractions and inflammation. When NSAIDs block this enzyme, they help reduce pain and inflammation. This is their primary benefit.
• COX-1 also protects the stomach by its release of prostaglandins that protect the mucous layer, maintain normal bicarbonate levels, and keep blood flowing in the intestinal tract. When NSAIDs block COX-2, they expose the mucous lining to attack.

Standard NSAIDs block both COX-1 and COX-2. Even if an NSAID is injected intravenously, the drug will still inhibit prostaglandins in the stomach and duodenum. NSAIDs are mild acids and can cause some injury by direct exposure to the lining of the stomach. Their primary damaging effects, however, are from their actions against COX-1. Studies suggest the following risks:

• An analysis of controlled trials reported that about 1% of patients taking aspirin over a 28 month period will experience gastrointestinal bleeding. A significant risk existed even at low doses or with the use of modified-release formulations.
• Of further concern was a 1998 study indicating that taking NSAIDs for only six months posed a risk for symptomatic ulcers that was greater than 1%.

The risk for bleeding is continuous for as long as a patient is on these drugs and may even persist for about a year after taking them. Taking short courses of NSAIDs for temporary pain relief should not cause major problems because the stomach has time to recover and repair any damage that has occurred.

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Herpes simplex

Definition

Herpes simplex is an infection that mainly affects the mouth or genital area.

Causes

There are two different strains of herpes simplex viruses:

• Herpes simplex virus type 1 (HSV-1) is usually associated with infections of the lips, mouth, and face. It is the most common herpes simplex virus and most people develop it in childhood. HSV-1 often causes lesions inside the mouth, such as cold sores (fever blisters), or infection of the eye (especially the conjunctiva and cornea). It can also lead to infection of the lining of the brain (meningoencephalitis). It is transmitted by contact with infected saliva. By adulthood, up to 90% of people will have antibodies to HSV-1.
• Herpes simplex virus 2 (HSV-2) is sexually transmitted. Symptoms include genital ulcers or sores. In addition to oral and genital sores, the virus can also lead to complications such as infection of the lining of the brain and the brain itself (meningoencephalitis) in neonatal infants due to infection during birth. However, some people have HSV-2 but do not show symptoms. Up to 30% of U.S. adults have antibodies against HSV-2. Cross-infection of type 1 and 2 viruses may occur from oral-genital contact.

A finger infection, called herpetic whitlow, is another form of herpes. It usually affects health care providers who are exposed to saliva during procedures. Sometimes, young children also can get the disease.

The herpes virus can infect the fetus and cause abnormalities. A mother who is infected with herpes may transmit the virus to her newborn during vaginal delivery, especially if the mother has an active infection at the time of delivery.

It's possible for the virus to be transmitted even when there are no symptoms or visible sores.

Symptoms

• Mouth sores
• Genital lesions -- there may first be a burning or tingling sensation
• Blisters or ulcers -- most often on the mouth, lips and gums, or genitals
• Fever blisters
• Fever -- especially during the first episode
• Enlarged lymph nodes in the neck or groin

Exams and Tests

Many times, doctors can tell whether you have a herpes-simplex infection simply by looking at the lesions. However, certain tests may be ordered to be sure of the diagnosis. These tests include:

• Blood test
• Viral culture of the lesion
• Direct fluorescent antibody (DFA) test

Treatment

Some cases are mild and may not need treatment.

People who have severe or prolonged cases, immune system problems, or frequent recurrences may need to take antiviral medications such as acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex).

People who have more than 6 recurrences of genital herpes per year may need to continue taking antiviral medications to reduce recurrences.

Support Groups

Support groups and dating services are available for people with genital herpes.

Outlook (Prognosis)

The oral or genital lesions usually heal on their own in 7 to 10 days. The infection may be more severe and last longer in people who have a condition that weakens the immune system.

Once an infection occurs, the virus spreads to nerve cells and stays in the body for the rest of a person's life. It may come back from time to time and cause symptoms, or flares. Recurrences may be triggered by excess sunlight, fever, stress, acute illness, and medications or conditions that weaken the immune system (such as cancer, HIV/AIDS, or the use of corticosteroids).

Possible Complications

• Meningitis
• Encephalitis
• Eczema herpetiform (widespread herpes across the skin)
• Infection of the eye -- keratoconjunctivitis
• Prolonged, severe infection in immunosuppressed individuals
• Pneumonia
• Infection of the trachea

When to Contact a Medical Professional

Call your health care provider if you develop symptoms which appear to be herpes infection. There are many different conditions that can cause similar lesions (especially in the genital area).

If you have a history of herpes infection and develop similar lesions, tell your health care provider if they do not get better after 7 to 10 days, or if you have a condition that weakens your immune system.

Prevention

Preventing herpes simplex is difficult since people can spread the virus even when they don't have any symptoms of an active outbreak.

Avoiding direct contact with an open lesion will lower the risk of infection.

People with genital herpes should avoid sexual contact when they have active lesions. Safer sex behaviors, including the use of condoms, may also lower the risk of infection.

People with active herpes lesions should also avoid contact with newborns, children with eczema, or people with suppressed immune systems, because these groups are at higher risk for more severe disease.

To decrease the risk of infecting newborns, a cesarean delivery (C-section) is recommended for pregnant women who have an active herpes simplex infection at the time of delivery.

References

Workowski KA, Berman SM. Sexually Transmitted Diseases Treatment Guidelines, 2006. MMWR Morb Mortal Wkly Rep. August 4, 2006;55(RR-11):1-94.

Stoopler ET. Oral herpetic infections (HSV 1-8). Dent Clin North Am. 2005 Jan;49(1):15-29, vii.

Mandell GL, Bennett JE, Dolin R. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000.

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Cranial mononeuropathy III - compression type

Definition

Cranial mononeuropathy III is a problem with the function of the third cranial nerve, which is located behind the eye.

Alternative Names

Third cranial nerve palsy; Oculomotor palsy; Pupil-involving third cranial nerve palsy

Causes

Cranial mononeuropathy III - compression type is a mononeuropathy, which means that only one nerve is affected. It affects the third cranial (oculomotor) nerve, one of the cranial nerves that controls eye movement. Local tumors or swelling can press down on and damage the nerve.

Causes may include:

• Brain aneurysms
• Disorders such as mononeuritis multiplex
• Infections
• Poorly formed blood vessels (vascular malformations)
• Sinus thrombosis
• Tissue damage from loss of blood flow (infarction)
• Trauma (from head injury or caused accidentally during surgery)
• Tumors or other lesions (especially tumors at the base of the brain and pituitary gland)

Rarely, people with migraine headaches may have a temporary problem with the oculomotor nerve. This is probably due to a spasm of the blood vessels. In some cases, no cause can be found.

Symptoms

• Double vision
• Drooping of one eyelid
• Headache or eye pain

Other symptoms may occur if the cause is a tumor or trauma. Decreasing consciousness is a serious sign, because it could indicate brain damage or death.

Exams and Tests

An eye examination may show:

• Enlarged (dilated) pupil of the affected eye
• Eye movement abnormalities
• Eyes that are not aligned (dysconjugate gaze)

A complete medical and nervous system (neurological) examination can show whether any other parts of the body are affected.

Other tests may include:

• Blood tests
• CT angiogram
• CT scan
• MRI
• Spinal tap (lumbar puncture)

Treatment

Some cases may get better without treatment. Treating the cause (if it can be found) may relieve the symptoms in many cases.

Treatment may include:

• Corticosteroid medications to reduce swelling and relieve pressure on the nerve
• Surgery to treat eyelid drooping or eyes that are not aligned
• Wearing an eye patch or prisms

Outlook (Prognosis)

Some cranial nerve dysfunctions will respond to treatment. A few cases result in some permanent loss of function. If the problem is caused by brain swelling due to a tumor or stroke, those conditions may be life-threatening.

Possible Complications

• Permanent eyelid drooping
• Permanent vision changes

When to Contact a Medical Professional

Call the local emergency number (such as 911) or go to the emergency room if you have:

• Double vision
• No feeling in or control over parts of your body
• Signs of changed consciousness
• Unusual headache

Prevention

Quickly treating disorders that could press down on the nerve may reduce the risk of developing cranial mononeuropathy III.

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