A patient with painless ophthalmoplegia may present with paresis of the extra-ocular muscles without pain.
Most of these conditions present with an insidious onset.
Possible causes of painless ophthalmoplegia usually includes:
(1) thyroid-associated orbitopathy (TAO)
(2) orbital lymphoma
(3) myasthenia gravis, generalized (GMG) or orbital (OMG)
(4) oculopharyngeal muscular dystrophy (OPMD)
(5) mitochondrial disorder
Rarely a patient with orbitoal myositis may present with no or minimal pain.
