The Ophthalmology Unit, Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.
The Ophthalmology Department, SarawakGeneralHospital,
Kuching, Sarawak, East Malaysia.
third nerve palsy
Photo by Professor Chua
This 19 year-old woman
attended the clinic wanting to have her left exotropia corrected. The vision
in this eye was 6/36 unaided. The deviation had been present since
childhood. Examiantion showed left ptosis with lateral deviation. The
extraocular movement was limited mainly on adducation and downgaze with some
limitation on upgaze but the pupil was not involved. The ptosis and ocular
deviation did not show variability to indicate myasthenia gravis. A CT head
scan showed no abnormalities. Orthoptic assessment using prism suggested
that she may get post-operative diplopia. After explaining the findings to
the patient, she agreeded not to undergo any operations for the time being.
Left partial ptosis and extropia.
Limited eye movement mainly on
adduction and downgaze.