For parkinsonian disorders, progressive supranuclear palsy (PSP) continues to be significant for differential diagnosis. PSP presents a range of ocular abnormalities that have been suggested as optional tools for its early detection, apart from the principal characteristic of postural unsteadiness. Nonetheless, such symptoms may be difficult to identify, particularly during the early onset stage of the disorder. It may also be problematic to recognize these symptoms for general practitioners who lack the required experience or physicians who are not specifically educated and proficient in ophthalmology or neurology. Thus, here, a methodical evaluation was carried out to identify seven oculomotor abnormalities occurring in PSP, comprising square wave jerks, the speed and range of saccades (slow saccades and vertical supranuclear gaze palsy), ‘round the houses’ sign, decreased blink rate, blepharospasm, and apraxia of eyelid opening. Inspections were conducted using direct visual observation. An approach to distinguish these signs during a bedside examination was also established. When presenting in a patient with parkinsonism or dementia, the existence of such ocular abnormalities could increase the risk of PSP. For the distinction between PSP and other parkinsonian disorders, these signs hold significant value for physicians. The authors urge all concerned physicians to check for such abnormalities with the naked eye in patients with parkinsonism. This method has advantages, including ease of application, reduced time-consumption, and requirement of minimal resources. It will also help physicians to conduct efficient diagnoses since many patients with PSP could intially present with ocular symptoms in busy outpatient clinics.

中文翻译：

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如何发现进行性核上性麻痹的眼部异常？实际审查

对于帕金森病，进行性核上性麻痹 (PSP) 继续对鉴别诊断具有重要意义。除了姿势不稳的主要特征外，PSP 呈现出一系列眼部异常，这些异常被建议作为早期检测的可选工具。尽管如此，这些症状可能难以识别，特别是在疾病的早期发作阶段。对于缺乏所需经验的全科医生或未受过专门教育且精通眼科或神经科的医生来说，识别这些症状也可能存在问题。因此，在这里，进行了有条不紊的评估，以确定 PSP 中发生的七种动眼神经异常，包括方波抽搐、扫视的速度和范围（慢扫视和垂直核上性凝视麻痹），“圆屋”征、眨眼频率降低、眼睑痉挛和眼睑张开失用。使用直接目视观察进行检查。还建立了在床边检查期间区分这些体征的方法。当出现在患有帕金森症或痴呆症的患者时，这种眼部异常的存在可能会增加 PSP 的风险。对于 PSP 和其他帕金森病的区别，这些迹象对医生具有重要价值。作者敦促所有相关的医生用肉眼检查帕金森病患者的这种异常情况。该方法具有易于应用、减少时间消耗和所需资源最少等优点。