Gaze disease, more accurately termed a conjugate gaze palsy, refers to the inability to move both eyes together in a single, coordinated direction, typically horizontally or vertically.
Understanding Conjugate Gaze Palsy
A conjugate gaze palsy isn't a disease itself but rather a sign of an underlying neurological condition. It indicates a problem with the brain's control of eye movements. The most frequent form of gaze palsy affects horizontal eye movements, although issues can also occur with upward or downward gaze.
Types of Gaze Palsies
- Horizontal Gaze Palsy: Difficulty moving both eyes together to the left or right. This is the most common type.
- Vertical Gaze Palsy: Difficulty moving both eyes together upwards or downwards. Upward gaze palsies are more common than downward gaze palsies.
Causes
The causes of gaze palsy are varied and can include:
- Stroke: Damage to brain areas controlling eye movement.
- Brain tumors: Lesions that interfere with the neural pathways for eye movement.
- Multiple sclerosis (MS): Demyelination affecting the brainstem.
- Brainstem lesions: Damage to the brainstem, which houses crucial eye movement control centers.
- Wernicke's encephalopathy: A thiamine deficiency causing brain damage.
- Certain medications: Some drugs can have side effects that affect eye movement.
- Progressive supranuclear palsy (PSP): A rare brain disorder that causes problems with movement, including eye movement.
- Congenital conditions: Rarely, gaze palsies can be present from birth.
Symptoms
The primary symptom is the inability to move both eyes together in the affected direction. Other symptoms may include:
- Double vision (diplopia): This can occur when the eyes are not aligned.
- Head tilting: Patients may tilt their head to compensate for the eye movement deficit.
- Difficulty reading or following moving objects.
- Balance problems.
Diagnosis
Diagnosis typically involves a neurological examination, including assessment of eye movements. Imaging studies such as MRI or CT scans of the brain may be performed to identify the underlying cause.
Treatment
Treatment focuses on addressing the underlying cause of the gaze palsy. For example:
- Stroke: Rehabilitation and therapies to improve overall neurological function.
- Brain tumors: Surgery, radiation therapy, or chemotherapy.
- Wernicke's encephalopathy: Thiamine supplementation.
In some cases, prism glasses can help to alleviate double vision. Eye muscle surgery may also be an option in certain situations.
