Evaluation of exercises for treating ocular cranial nerve palsis
Research type
Research Study
Full title
Non-invasive self-management treatment for Ocular Cranial nerve PALSies: The OCPALS study
IRAS ID
311009
Contact name
Sean Gallagher
Contact email
Sponsor organisation
University of Liverpool
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Research Summary
Ocular cranial nerve palsy (OCNP) is a condition whereby the nerves supplying the muscles which move the eyes are damaged, causing the eyes to become misaligned, producing double vision. Double vision is a debilitating visual disorder impacting sufferer’s quality of life. A study reports a median average recovery of 3 months, with those unresolved after 6 months usually remaining persistent as a chronic long-term condition (Kim et al, 2018). Currently the only acute treatments for OCNP involve either covering one eye to eliminate one of the double images, a temporary prism placed onto a pair of spectacles in an attempt to join the double images, or by advising patients to move their heads into a specific posture to shift the eyes into a less symptomatic position.
In other eye movement disorders exercises are prescribed to improve function. Currently there is no evidence for exercises benefitting patients with OCNP due to poor study design and lack of detail in exercises prescribed. The aim of this study is to develop a clinically acceptable exercise which will improve the speed of recovery or rate of recovery for patients. Therefore, this study is a feasibility study to design an exercise package that is clinically acceptable.Summary of Results
Ocular cranial nerve palsy (OCNP) is a condition whereby the nerves supplying the muscles which move the eyes are damaged, causing the eyes to become misaligned, and producing double vision. Double vision is a debilitating visual symptom impacting sufferer’s quality of life. There is an average recovery of 3 months, with those unresolved after 6 months usually having persistent double vision as a chronic long-term condition. Currently the only acute treatments for OCNP involve either covering one eye with a patch to eliminate one of the double images, using a temporary prism placed onto a pair of glasses in an attempt to join the double images, or by advising patients to turn or tilt their heads to one side to shift their eyes into a less symptomatic position.
In other eye movement disorders eye exercises are prescribed to improve eye movement function. Currently there is no evidence for eye exercises in benefitting patients with OCNP due to poor study design and lack of detail in the exercises prescribed. The aim of this study was to develop a clinically acceptable exercise and assess if this is feasible and acceptable for clinicians and patients to use.
We recruited 28 patients with OCNP (mix of 3rd, 4th and 6th nerve palsies) and all started treatment with a novel training package of eye exercises. Two patients withdrew from the study during follow-up. For the remaining patients, use of the eye exercise training package was found to be acceptable and feasible to do. Interviews with clinicians and patients provided useful information to refine the instructions for how to use the exercises. The next step for this study is to evaluate the eye exercise training pack in a randomised trial.REC name
West of Scotland REC 3
REC reference
22/WS/0054
Date of REC Opinion
6 May 2022
REC opinion
Favourable Opinion