The AAO Journal, 2024/06, 34(2):21. doi: 10.53702/i2375-5717-34.2.16, type of study: ,cr,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Full text    (https://meridian.allenpress.com/aaoj/article/34/2/16/500954/LBORC-NUFA-Poster-Abstracts-2024-Students)

Keywords:

abducens nerve palsy [1]
case report [736]
eyes [23]
female [654]
OMT [3924]
osteopathic manipulative treatment [3945]
women [607]

Abstract:

Introduction/Background: Abducens nerve palsy is the most common isolated ocular nerve palsy. Multiple etiologies have been linked to isolated abducens nerve palsy, including viral infections. Strikingly, isolated abducens nerve palsy has been reported in patients with PCR-confirmed COVID-19 infections and after receiving the COVID-19 vaccination. Most cases resolved spontaneously, however some patients experienced persistent intermittent diplopia after recovery from COVID-19. Case: A 56-year-old female presented to the clinic reporting headaches, neck pain, and diplopia. Ocular mobility examination revealed right abduction deficiency. The patient reports these symptoms appeared approximately 1 month prior. The patient had a similar episode after receiving the COVID-19 vaccine that had resolved spontaneously but has now reappeared. A physical exam exhibited no additional abnormalities. Osteopathic structural exam revealed right frontal, temporal and occipitomastoid suture restriction. Osteopathic manipulative treatment (OMT) was employed utilizing balanced ligamentous tension, osteopathic cranial manipulative medicine, and myofascial release. Results: Immediately after treatment, the patient reported improvement in her headache. An ocular mobility examination was repeated and exhibited approximately 20% improvement in right eye abduction. The patient is scheduled to return to the clinic for additional treatment in two weeks. Discussion: This case demonstrates, for the first time, improvement of persistent isolated abducens nerve palsy with OMT. The limitations of these conclusions include subjective evaluation of degree of abduction of the right eye before and after treatment. Additional research on treatment options for patients with persistent isolated abducens nerve palsy is needed as not all cases resolve spontaneously and can impact patient’s quality of life.