Colette's Eye Complications: A Case Study

My eighty-four-year-old neighbor, Colette, has come to me to talk about how she is having eye complications after a recent fall to the head. After reviewing the symptoms, I think Colette has damaged her oculomotor nerve, cranial nerve IV. Furthermore, the inferior rectus is in charge of depressing, adducting, and laterally rotating the eye (Schuenke, Schulte, & Schumacher 2016). Similarly, the inferior rectus muscle positions the eye infraversion, dextrodepression, levodepression, dextrocycloversion, and levocycloversion. Infraversion is when the right or left inferior causes the eye to look straight down while dextrodepression causes the right inferior rectus to look right and downward. On the other hand, the levodepression is when the left …show more content…
Colette is experiencing double vision, also known as diplopia, which is a red flag that something internally is wrong, and a symptom of third nerve palsy (Nordqvist 2014). Additionally, Colette is experiencing mydriasis, dilated pupils, on the right eye only in this case (Stöppler 2013). As far as having difficulty fully elevating eyelid, the levator palpebrae superioris muscle could be not functioning correctly, and is also innervated by oculomotor nerve (Drake, Mitchell, & Vogl 2012). Therefore, if the oculomotor nerve is damaged then, the levator palpebrae superioris cannot be innervated, and produces a droopy eyelid (“Third Nervve Palsy” 2016). Colette’s right eye is lateral and depressed, which are the functions of the inferior rectus eye muscle (Schuenke, Schulte, & Schumacher …show more content…
The oculomotor nerve is located in the anterior portion of the brainstem by the midbrain and pons. First, the oculomotor nerve goes through the dura mater, more specifically, the tentorium cerebelli. Next, the oculomotor goes through the lateral portion of cavernous sinus through the superior orbital fissure (“The Oculomotor Nerve” & Drake, Mitchell, & Vogl 2012). At this point, the general somatic efferent fibers innervate the inferior rectus and the levator palpebrae superioris. On the other hand, the general visceral efferent fibers synapse in ciliary ganglion by preganglionic parasympathetic fibers to innervate ciliary muscles, and sphincter pupillae muscles. The general visceral efferent fibers allow the pupils to constrict, and shape the lens by the ciliary bodies (Drake, Mitchell, & Vogl 2012). Colette will not have dry eye due to third nerve palsy because dry eye correlates with ophthalmic nerve, V1, first branch off the trigeminal nerve, and facial nerve, cranial nerve VII. If there is impairment to parasympathetic fibers of the facial nerve that travels via the ophthalmic nerve to lacrimal gland, then an individual will have dry eye (Drake, Mitchell, & Vogl