Ocular motility consequences following lesions of the thalamus: a literature review

Aim: To summarise the anatomy and function of the thalamus and review the medical literature for types of thalamic lesions and resultant ocular motility deficits.

Methods: A literature search was undertaken using the PubMed and Web of Knowledge databases. Non- English-language studies were not included.

Results: Types of thalamic lesions included vascular infarct or haemorrhage, space-occupying lesions, birth trauma, and associated periventricular leucomalacia. Ocular motility deficits included vertical gaze palsies, skew deviation, convergence anomalies, third nerve palsy, nystagmus, pupil and lid anomalies, together with saccadic and smooth pursuit deficits.

Conclusion: Vascular pathology is the most common cause of thalamic lesions. The lesions may be partial or complete, and unilateral or bilateral. The predominant ocular motility deficit reported is that of vertical gaze palsy. Commonly involvement of the midbrain also occurs.