Literature review:
We searched PubMed and Google Scholar from 1stDecember 2019 to the end of March 2021, we found six articles with a
total of 9 patients with ophthalmoparesis secondary to cranial
mononeuropathy as a possible neurological manifestation of COVID-19. We
excluded patients critically ill, post-intubation, and Miller Fischer
patients. Females were the majority (6/9 ;66.7%). The mean age of the
patients was 42 ±14.1 years (range 2-71); most of them were previously
healthy. Out of nine patients, two had third nerve palsy; and seven had
sixth nerve palsy. The onset of ophthalmoparesis varied but usually
manifested 3-8 days after the start of respiratory symptoms. MRI was
done and was unremarkable in 4 out of 6 patients (similar to our
patient), interestingly, 7 patients had mild symptoms such as, fever,
shortness of breath, anosmia, ageusia, and cough, whereas 2 patients
required supplemental oxygen.
Outcomes were documented in 6 patients who responded favorably to
conservative treatment and had resolution of the ophthalmoparesis after
14 days to 6 weeks. The cases are summarized in table (1).