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September 1988

Diabetic Superior Division Oculomotor Nerve Palsy

Author Affiliations

Fort Gordon, Ga
Augusta, Ga

Arch Ophthalmol. 1988;106(9):1169-1170. doi:10.1001/archopht.1988.01060140329017

To the Editor.  —The oculomotor nerve bifurcates into two branches in the anterior cavernous sinus. The superior division supplies the levator palpebrae superioris and superior rectus muscles. The inferior division innervates the inferior rectus, medial rectus, and inferior oblique muscles; it also sends parasympathetic fibers to the ciliary body and pupillary sphincter. Isolated superior division oculomotor nerve palsies are rare and generally result from structural lesions. We describe a patient with a diabetic superior division third-nerve palsy that spontaneously resolved after eight weeks.

Report of a Case.  —A 68-year-old white man presented to the Dwight David Eisenhower Army Medical Center, Fort Gordon, Ga, with vertical diplopia. The patient reported the subacute onset of right upper lid ptosis, vertical binocular diplopia, and a mild right periorbital headache. Other medical problems included insulin-dependent diabetes mellitus, hypertension, and coronary heart disease.Ophthalmologic examination revealed a visual acuity of 20/20 OU. The pupils were

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