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She never complained of diplopia despite binocular vision and progressive recovery of strabismus, excluding uncovering of visual fields. We describe the case of a 41-year-old woman presenting with right oculomotor paresis and left object-centred visual neglect due to a right fronto-parietal haemorrhage expanding to the right peri-mesencephalic cisterna caused by the rupture of a right middle cerebral artery aneurysm.
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When strabismus is present, absence of diplopia has to induce the research of either uncovering of visual fields or monocular suppression, amblyopia or blindness. Oculomotor nerve disease is a common cause of diplopia. Treatment with acetazolamide led to significant improvement, supporting the use of acetazolamide in this rare condition.īier, J C Vokaer, M Fery, P Garbusinski, J Van Campenhoudt, G Blecic, S A Bartholomé, E J Although her cough was effectively treated and intracranial pressure measurement was normal, her ophthalmic symptoms continued to progress, which is common in previous cases reported. We report the first case of midbrain keyhole aqueduct syndrome with ocular motor and other neuro-ophthalmic manifestations associated with severe cough.
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Her nystagmus and diplopia improved with oral acetazolamide treatment, at high doses of 2500-3000 mg per day. Brain magnetic resonance imaging showed a 1.5 mm Ã- 11.7 mm Ã- 6 mm midline cleft in the ventral midbrain communicating with the cerebral aqueduct, consistent with keyhole aqueduct syndrome. She also had a right-sided ptosis and a 3 mm anisocoria not due to cranial nerve 3 paresis or Horner's syndrome. There was an incomitant left hypertropia due to skew deviation that worsened with right and up gazes and improved with down gaze. Gaze evoked nystagmus and mild paresis were also seen with up gaze. Examination revealed a 1-2 Hz down-beating nystagmus in primary gaze that worsened with left, right, and down gazes. A 58-year-old woman with a 2-year history of daily, severe cough presented to the neuro-ophthalmology clinic with progressive diplopia and oscillopsia. We report a rare case of keyhole aqueduct syndrome presenting after two years of severe cough due to gastroesophageal reflux disease. Midline structural defects in the neural axis can give rise to neuro-ophthalmic symptoms. Oh, Angela Jinsook Lanzman, Bryan Alexander Liao, Yaping Joyce Vertical diplopia and oscillopsia due to midbrain keyhole aqueduct syndrome associated with severe cough. © 2015 Board of regents of the University of Wisconsin System, American Orthoptic Journal, Volume 65, 2015, ISSN 0065-955X, E-ISSN 1553-4448. This paper reviews the pathophysiology of macular diplopia, describes the binocular pathology causing the diplopia, discusses the clinical evaluation, and reviews the present treatments including some newer treatment techniques. The effect that the maculopathies have on the interaction of central sensory fusion and peripheral fusion are different than the usual understanding of treatment for diplopia. Maculopathies affect point-to-point foveal correspondence causing diplopia. Shippman, Sara Cohen, Kenneth R Heiser, Larissa In this article, we present a case of horizontal diplopia following cosmetic upper blepharoplasty we review the literature on this unexpected complication and offer some recommendations to avoid it. Most of the cases are in its vertical form due to trauma of the extraocular muscles. Horizontal Diplopia Following Upper Blepharoplastyįull Text Available Diplopia is an infrequent complication after blepharoplasty. Here, we present a 57-year-old man with binocular horizontal diplopia that occurred during left direction gaze due to dacryops. Diplopia due to dacryops has not been reported previously. It is known that it can cause globe displacement, motility restriction, and proptosis because of the mass effect. Directory of Open Access Journals (Sweden)įull Text Available Dacryops is a lacrimal ductal cyst.