Insiden dan Etiologi Kelumpuhan Saraf III, IV dan VI yang disertai Diplopia Binokuler di RSUD DR. Wahidin Sudirohusodo

Rini Kusumawar Dhany, Yunita Tanjung, Farren Jennel


The purpose of this study is to determine the incidence and etiology of III, IV and VI nerve paralysis with binocular diplopia in RSUD dr. Wahidin Sudiro Husodo General Hospital Mojokerto. Method of this study was descriptive study using secondary medical record data. Incidence rates are adjusted for age and sex distribution of the population. The mean age of onset was 45.6 years, seven male subjects (58.3%) and five female subjects (41.7%). We identified 12 cases of acquired III, IV and VI nerve palsy over a 4-year period. The most common cause of binocular diplopia was sixth nerve palsy (33.3%), 3 patients experienced partial third nerve palsy (25%), one patient with third nerve palsy with pupil sparing (8.3%). Most common etiology was microvascular (58,3%), neoplasms (16.7%), aneurysms (8.3%) trauma (8.3%), and post meningioma neurosurgery (8.3%). Six patients (50%) with microvascular third nerve palsy had diabetes mellitus, while 1 patient (8.3%) had grade 2 hypertension. The most common cause of binocular diplopia was VI nerve palsy. Risk factors such as hypertension and diabetes mellitus which have a significant effect on diplopia. Patients with N. III, IV and VI palsy need to be done early MRI examination so that complications and progression can be prevented.


kelumpuhan saraf ke III, IV, VI; diplopia binokuler; neuropati mikrovaskuler

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Comer RM, Dawson E, Plant G, Acheson JF, Lee JP, 2007. Causes and outcomes for patients presenting with diplopia to an eye casualty department. Eye (Lond). 21(3):413-8.

Cornblath WT, 2014. Diplopia due to ocular motor cranial neuropathies. Continuum (Minneap Minn). 20: 966-80

Dinkin M, 2014. Diagnostic approach to diplopia. Continuum (Minneap Minn). 20 (4 Neuro-ophthalmology): 942-965

Graham C and Mohseni M, 2019. Abducens Nerve (CN VI) Palsy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; Available from:

Harder N, 2010. Temporal arteritis: an approach to suspected vasculitides. Prim Care. 37(4):757-66

Holmes JM, Mutyala S, Maus TL, Grill R, Hodge DO, Gray DT, 1999. Pediatric third, fourth, and sixth nerve palsies: A population-based study. Am J Ophthalmol. 127:388-92

Ilyas S, 2009. Ikhtisar Ilmu Penyakit Mata. Jakarta: Balai Penerbit FKUI

Lutwak N, 2011. Binocular Double Vision - A Review. American Journal of Clinical Medicine. 8(3): 166-169

Merino P, Fuentes D,Gómez de Liaño P,Ordóñez MA, 2017. Diplopía binocular en un hospital terciario: etiología, diagnóstico y tratamiento. Archivos de la Sociedad Española de Oftalmología. 92(12): 565-570

Morillon P and Bremner F, 2017. Trochlear nerve palsy. Br J Hosp Med (Lond). 78:C38-C40

Sreedhar A and Menon A. 2019. Understanding and evaluating diplopia. Kerala Journal of Ophthalmology. 31(2): 102-111

Tamhankar MA and Volpe NJ, 2015. Management of acute cranial nerve 3, 4 and 6 palsies role of neuroimaging. Current Opinion in Ophthalmology. 26(6): 464-46



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