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).