Abducens Nerve Palsy

Abducens nerve palsy involves dysfunction of the sixth cranial nerve, which innervates the lateral rectus muscle, crucial for horizontal eye abduction. Etiologies include microvascular ischemia related to diabetes or hypertension, intracranial tumors, trauma, increased intracranial pressure, infections, and inflammatory neuropathies. Clinically, patients present with horizontal diplopia, esotropia of the affected eye, and compensatory head turning to align vision. Diagnosis requires careful neuro-ophthalmologic examination and neuroimaging, typically MRI, to exclude compressive lesions. Management is etiology-dependent, ranging from observation and prism correction for ischemic cases to surgical intervention in structural lesions, with prognosis generally favorable if the underlying cause is addressed promptly.