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Nuclear 3rd CN Palsy with Vertical Gaze Palsy A patient with significant vasculopathy risk factors (DM, HTN, dyslipidemia), had a stroke affecting the right thalamus, midbrain, and right cerebellum due to basilar artery occlusion. He had a successful mechanical thrombectomy with a stent retriever a…

Restrictive Strabismus Secondary to a Large Encapsulated Non-Valved Glaucoma Drainage Implant Fibrotic Capsule A patient with a history of primary open angle glaucoma of both eyes and myopic degeneration with amblyopia and chronic poor central vision of the right eye presented with elevated intraoc…

Motility Disturbances after Glaucoma Drainage Device A patient with a history of traumatic angle recession glaucoma in the left eye presented with acute onset of double vision and persistent ocular soreness in the left eye. He denied generalized weakness or difficulty with respiration. His surgical…

Esotropic Duane Retraction Syndrome, Right Eye An adult patient was referred to our service for strabismus evaluation due to crossing of the eyes. Patient complained of having difficulty looking towards the right side, which had occurred since childhood. The patient also reported moderate to severe…

Heavy Eye Syndrome/Adult Onset Esotropia Secondary to High Axial Myopia A patient with history of amblyopia right eye, and no previous ocular surgery or childhood strabismus presents with large angle esotropia and hypotropia. Exam was notable for hand movements vision in the right eye and 20/20 in …

Marfan Syndrome with Ectopia Lentis A young child presented to the ophthalmology clinic with blurry vision. Slit lamp examination was notable for superotemporally subluxed lenses in both eyes, along with a tall slender body frame. Due to these findings, the patient was referred to a geneticist and …

Patient with Brown Syndrome with images and videos showing for esotropia which was worse in left gaze, hypotropia of left eye worse in right gaze and upgaze accompanied by limited elevation OS in adduction and incyclotorsion left eye, and restriction of extraocular movement of both eyes.

Brown Syndrome A patient was diagnosed with thyroid eye disease (TED) 2 years before presenting to our clinic. He complained of horizontal and vertical diplopia. The diplopia was constant and affected distance vision only. The patient was previously treated with teprotumumab. His exam was notable f…

Hermansky-Pudlak Syndrome An infant was brought to the emergency department by his mother referred from his pediatrician after a routine well-child visit. Parents had noticed severe light sensitivity, but patient was otherwise developing well. Patient grimaced to light in both eyes but had poor fix…

Chronic External Progressive Ophthalmoplegia A 36-years-old female patient presents to pediatric ophthalmology clinic at BPEI for a second opinion regarding progressive bilateral ptosis and exotropia. The patient has a history of progressive bilateral ptosis OS>OD and limitation of ocular moveme…

Ocular Neuromyotonia A child with a history of left exotropia secondary to a congenital third nerve palsy treated with strabismus surgery and ptosis repair presented with sudden onset intermittent left upper lid twitching and involuntary eye movements. Patient had no previous history of intracrania…

Optic Disc Drusen with Structural and Functional Changes A young child presented with crossing of the eyes without headaches or associated neurologic symptoms. Visual acuity was OD 20/30 and OS 20/40. Motility examination demonstrated moderate angle esotropia with full versions. Intraocular pressur…

Restrictive Strabismus and Brown Syndrome Secondary to Graves’ Disease A 68-year-old male with restrictive strabismus and Brown syndrome with extraocular movement restriction secondary to TED. He was on clinical trial for Teprotumumab 302 and had prior RAI ablation. His visual acuity OD is 20/20,…

Strabismus Secondary to a Glaucoma Drainage Implant A 10-year-old female was referred to the clinic for strabismus evaluation. She had a complex past ocular history including a congenital cataract OD s/p CE/IOL OD at 8 weeks old, RXT s/p RLR recession and RMR resection, IOL dislocation s/p PPV/lens…

Traumatic Transection of a Lateral Rectus Muscle by a Zygomatic Implant Zygomatic implants can be used to support dental prostheses in patients with inadequate maxillary bone volume. While maxillary sinusitis is the most common reported complication of ZI placement, rarely, intraorbital penetration…