Cranial Nerve Palsy as the Most Common Presentation of NeuroOphthalmic Conditions at Hospital Universiti Sains Malaysia – An 8- Year Review

Abstract Objective: To review cranial nerve palsy as the most common presentation of neuro-ophthalmic conditions presenting to Ophthalmology Clinic, Hospital Universiti Sains Malaysia, Kelantan. Methods: Retrospective case review of patients with neuroophthalmic conditions presenting to Ophthalmology Clinic, Hospital Universiti Sains Malaysia, Kelantan during the period of January 2005 to December 2012. Results: A total of 849 case records of neuro-ophthalmic conditions were reviewed. Neuro-ophthalmic conditions affected all age groups from birth to 80 years of age. The five most common conditions were cranial nerve palsies (27.8%), traumatic optic neuropathy (12.5%), optic neuritis (8.2%), pituitary tumours (7.5%), and ischaemic optic neuropathy (6.2%). The remaining comprised of other neuro-ophthalmic conditions such as papilloedema, optic nerve compression, cerebrovascular disorders, thyroid eye disease, myasthenia gravis, pupillary abnormalities and hereditary optic neuropathies. There was only one case of suspected giant cell arteritis, but the biopsy was inconclusive. Out of the cranial nerve palsies that presented to us, the most common were isolated 6th nerve (44.5%) and isolated 3 rd nerve (25.4%) palsies. Conclusion: In our series, the most common neuro-ophthalmic conditions presented to our neuro-ophthalmology clinic were cranial nerve palsies.