Concluded Case

Abducent nerve palsy right eye ball

First clinical photo is before the treatment Second clinical photo is after the treatment Discuss the case. Patient known diabetic on oral medication Complaints of double vision acute onset With insulin therapy his eye ball movement become normalized and double vision disappeared. Opine and discuss the case.

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This is the case of lateral rectus palsy of Right eye due to 6 cranial nerve involvement in the long standing uncontrolled diabetes ,is quite common. Insulin was started and on the 7 week of treatment ,patient showed the sign of improvement ,and able to move the right eye ball to the right temporal field. Regular monitoring of diabetes by the individual ,and by the physician is mandatory in the primary prevention of the DM induced complication.

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PATIENT IS DIABETIC WAS ON ORAL MEDECATION WHEN HE EXOERIENCED ACUTE ONSET OF DOUBLE VISIIN AND WHEN HE WAS PUT@INSULIN HIS OPHTHALMOPLEGIA AND DOUBLE VISION DESAPPEARED COMMENTS WE KNOW COMPLECATED D.M CAUSES OOHTHALMOPLEGIA AND DIABETIC RETINOPATHY PT WAS ON O H AGENTS AND HIS BLOOD SUGAR MUST NOT HAVE BEEN UNDER CONTROL SO HE EXPERIENCED ACUTE ONSET. OF OPHTHALMOPLEGIA AND DOUBLE VISION ONCE PUT ON INSULIN HIS BLOOD SUGAR GOT STABILISED SO OOHTHALMOPLEGIA AND DIPLOPIA DESAPPEARED

Great wonderful reply..
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COMPLECATIONS OF UNCONTROLLED D M DIABETIC RETINOPATHY D NEUROPATHY D NEPHROPATHY D ARTHOPATHY D DERMOPATH PERIODONTITIS DIABETIC FOOT ULCERS DEMENTIA ALZHEIMERS PRONE TO C V S DESORDERD C N S IN PRESENCE OF NEPHROPATHY RETINOPATHY IS SEVERE

Thanx dr Elumalai Subbarayan for tagging me Yes he is a opthalmoplegia which shows strabismus Since pt is diabetic retinopathy is to be r/o Strict control of sugar and if there is no retinopathy than surgical correction can be done

Thanx dr Durgesh Patel
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Ophthalmoplegia is a serious but not common condition of uncontrolled diabetes oculomotor nerve is affected in one of the study sixth nerve palsy is next common. Strict control of blood sugar by oral or if required by insulin will prevent diabetic retinopathy and other systemic complications and rare condition of hyperglycemia associated squint

Sparing of the pupil with paralysis of the third cranial nerve has been reported to be characteristic of diabetic ophthalmoplegia. Probably it's paresis of RIGHT LR which improved over some time.

It is Abducent nerve palsy sir .
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Lateral rectus weakness due to diabetic neuropathy ,or due to metabolic changes of uncontrolled DM. This is reversed with good control of DM.

Thank you,Doctor
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Diabetic Ophthalmoplegia/ Diplopia . Managed with adequate antidiabetic treatment. Check regularly It's glycemic index.

Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

? DIBETIC OPHTHALMOPLEGIA ..& .. DIBETIC NEUROPATHY..

Tnx Dr Vipin Bihari Jain sir
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This is the case of lateral rectus palsy of Right eye due to 6 cranial nerve involvement in the long standing uncontrolled diabetes ,is quite common. Insulin was started and on the 7 week of treatment ,patient showed the sign of improvement ,and able to move the right eye ball to the right temporal field. Regular monitoring of diabetes by the individual ,and by the physician is mandatory in the primary prevention of the DM induced complication.

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