Differential Diagnosis for Outward Right Eye Deviation
The patient's presentation of outward right eye deviation can be caused by various conditions. Here's a categorized differential diagnosis:
- Single most likely diagnosis
- Lateral rectus palsy or dysfunction: This is a common cause of outward eye deviation, also known as exotropia. The lateral rectus muscle is responsible for outward eye movement, and its dysfunction can lead to an inability to move the eye inward, resulting in outward deviation.
- Other Likely diagnoses
- Third cranial nerve (oculomotor) palsy: Although the third cranial nerve primarily controls inward eye movement, its palsy can also cause outward deviation due to the unopposed action of the lateral rectus muscle.
- Thyroid ophthalmopathy: This condition can cause exophthalmos (bulging of the eye) and lead to outward deviation of the eye.
- Stroke or cerebral vasculature issues: A stroke or other cerebral vasculature problems can affect the brain's control over eye movement, leading to outward deviation.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Increased intracranial pressure: Conditions like brain tumors, hemorrhages, or other causes of increased intracranial pressure can lead to outward eye deviation due to compression or damage to the cranial nerves.
- Cavernous sinus thrombosis: This is a rare but life-threatening condition that can cause outward eye deviation, among other symptoms.
- Orbital cellulitis or abscess: Infections in the orbit can cause outward deviation of the eye and are medical emergencies.
- Rare diagnoses
- Duane syndrome: A rare congenital condition that affects the muscles controlling eye movement, leading to limited or absent inward movement and possible outward deviation.
- Moebius syndrome: A rare neurological disorder that affects the muscles controlling facial expression and eye movement, potentially causing outward deviation.
- Gradenigo syndrome: A rare condition caused by inflammation or infection of the petrous apex of the temporal bone, leading to a combination of symptoms including outward eye deviation.