Ophthalmoplegia is the paralysis or weakness of the eye muscles. It can affect one or more of the six muscles that hold the eye in place and control its movement. Total ophthalmoplegia refers to the paralysis of all the muscles in the eye. People affected by ophthalmoplegia with orbital apex involvement may have double or blurred vision. They may also experience an inability to position the eyes in sync. Some may also have a hard time moving both eyes in every direction, and many will have drooping of their eyelids. Causes of ophthalmoplegia along with orbital apex involvement can be multiple sclerosis, trauma infarction, brain injury, stroke, thyroid disease, infection, associated with sinonasal malignancy, nasopharyngeal carcinoma, invasive fungal infections needing surgical removal and brain tumours