Objective: To review cranial nerve palsy as the most common 
presentation of neuro-ophthalmic conditions presenting to 
Ophthalmology Clinic, Hospital Universiti Sains Malaysia, 
Kelantan. 
Methods: Retrospective case review of patients with neuro
ophthalmic conditions presenting to Ophthalmology Clinic, 
Hospital Universiti Sains Malaysia, Kelantan during the period of 
January 2005 to December 2012. 
Results: A total of 849 case records of neuro-ophthalmic 
conditions were reviewed. Neuro-ophthalmic conditions affected 
all age groups from birth to 80 years of age. The five most 
common conditions were cranial nerve palsies (27.8%), traumatic 
optic neuropathy (12.5%), optic neuritis (8.2%), pituitary tumours 
(7.5%), and ischaemic optic neuropathy (6.2%). The remaining 
comprised of other neuro-ophthalmic conditions such as 
papilloedema, optic nerve compression, cerebrovascular 
disorders, thyroid eye disease, myasthenia gravis, pupillary 
abnormalities and hereditary optic neuropathies. There was only 
one case of suspected giant cell arteritis, but the biopsy was 
inconclusive.  Out of the cranial nerve palsies that presented to us, 
the most common were isolated 6th nerve (44.5%) and isolated 3rd 
nerve (25.4%) palsies. 
Conclusion: In our series, the most common neuro-ophthalmic 
conditions presented to our neuro-ophthalmology clinic were 
cranial nerve palsies.