The Ophthalmology Unit,  Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.

The Ophthalmology Department, Sarawak General Hospital, Kuching, Sarawak, East Malaysia.

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Aberrant third nerve regeneration

Photo by Professor Chua Chung Nen

A 23 year-old woman had had a right partial ptosis and exotropia since birth. Examination revealed poor ocular movement involving the extraocular muscles supplied by the third cranial nerve. The pupils in both eyes are equal and reactive to light. However, there was widening of the palpebral fissure on adduction and failure of the left upper eyelid to descend on downgaze. The features were consistent with aberrant third nerve regeneration. A CT scan was negative for any intracranial space-occupying lesion.

 

Widening of the palpebral fissure on adduction and failure of the lid

to descend on downgaze.

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