Introduction:

The oculomotor nerve palsy is rare in the general population, affecting mainly people over 60 years. It may course with eye pain, diplopia, ptosis, and strabismus. Hypertension and diabetes are its main etiologies. Mononeuropathies affect 3% of the diabetic population. It can be a manifestation of potentially fatal situations, such as cerebral aneurysms.

Case description:

A 55-year-old woman in good general condition, although with several important comorbidities, including type 1 diabetes mellitus with poor metabolic control. On May 12th of 2019, she reports the sudden onset of right supraciliary and ocular pain, with the following associated symptoms, also affecting the right eye: blurred vision, diplopia, photophobia, and new divergent strabismus. After two previous contacts with health institutions for this reason, she was referred to the emergency department by her family doctor, four days after the onset of the complaints, and was diagnosed with third nerve palsy. It was adopted an expectant attitude, with the spontaneous remission of symptoms occurring eight weeks later.

Comments:

The aim of this case is to warn of the importance of the family doctor in the continuity of health care because he/she is the assistant physician par excellence of his/her patient, will be the one who knows him best, and can easily value important new changes that may arise. On the other hand, it aims to emphasize the importance of quick action in the case of clinical suspicion of third nerve palsy, as well as the control of cardiovascular risk factors in a diabetic population.

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