Vertical Diplopia

Acierno, Marie D

doi:10.1055/s-2000-6830

Cited by 10 publications

(4 citation statements)

References 27 publications

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“…If these posterior ethmoidal branches were the main contributor of arterial supply, ischemic nerve block could be a possible mechanism. [6,7,8] Inflammation may contribute to the trochlear nerve palsy. However, no pain on eye movement and abrupt onset of the palsy did not indicate that it played a causative role in this patient.…”

Section: Discussionmentioning

confidence: 99%

Onodi cell mucocele causing isolated trochlear nerve palsy

Kwon

Kim

et al. 2019

Medicine

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Rationale: Acquired vertical diplopia is commonly observed in trochlear nerve palsy, often resulting from blunt head trauma or vascular problems. It is rarely caused by tumorous conditions or space occupying lesion. We report the first case of Onodi cell mucocele causing isolated trochlear nerve palsy. Patient concerns: A 62-year-old male noticed a double vision which worsened when looking down. On ophthalmologic examinations, the patient showed no abnormalities in visual acuity, intraocular pressure, and no swelling in optic disc. In ocular motility test, he was notable for 10° left hypertropia in primary position, 6° in right head tilt position, 14° in left head tilt position and this was aggravated in right and down gaze. Ostiomeatal complex CT depicted an expansile soft tissue density completely filling the left Onodi cell. Diagnoses: He was diagnosed with a trochlear nerve palsy caused by an isolated mucocele in the left Onodi cell. Interventions: Three days after presentation, he underwent endoscopic sinus surgery for marsupialization of the mucocele in the left Onodi cell. Outcomes: The mucocele was completely removed through the endoscopic endonasal approach. Within 4 months after surgery, his 4th nerve palsy had gradually and completely improved. Lessons: Onodi cell mucoceles that cause trochlear nerve palsy are extremely rare. Timely surgical decompression is essential to achieve optimal recovery of the neural function. Combined trochlear nerve palsy should be evaluated when Onodi cell mucocele involves the orbital apex from above.

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Section: Discussionmentioning

confidence: 99%

Onodi cell mucocele causing isolated trochlear nerve palsy

Kwon

Kim

et al. 2019

Medicine

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“…The complaint of vertical diplopia has a well‐established list of differential diagnoses including decompensated phoria, Myasthenia gravis, thyroid orbital diseases, mechanical interference of the globe or associated muscles, Brown’s syndrome, skew deviation or paralysis of the third or fourth cranial nerves 2 . The cause for the initial presentation was obviously related to the trauma.…”

Section: Discussionmentioning

confidence: 99%

Short‐ and long‐term vertical diplopia secondary to blunt trauma

Turnbull

Vingrys

Kalloniatis

2007

Clinical and Experimental Optometry

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This report describes the short-and long-term ocular signs and symptoms of a patient with an orbital blow-out fracture and discusses the differential diagnosis of vertical diplopia. A blow-out fracture occurs when blunt trauma is applied either directly to the eyeball itself or the orbital rim and usually results in a fracture of the orbital floor with consequential excavation and entrapment of orbital contents in the fracture. Vertical diplopia is a common presenting symptom for a blow-out fracture of the orbit but careful considerations should be given to other potential conditions leading to such diplopia. A patient is presented who suffered a blow-out fracture almost a decade earlier, secondary to blunt trauma to the globe. The clinical findings are provided immediately after the trauma, post-surgery and during a recent ocular examination.Short-and long-term vertical diplopia secondary to blunt trauma

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“…Common differentials are thyroid ophthalmopathy, blow-out fracture with inferior rectus entrapment, neurological causes like superior oblique palsy, neuromuscular junction abnormalities like myasthenia gravis or, in some cases, cysticercosis of the extraocular muscles. 1 'Silent sinus syndrome' is a rare condition where chronic maxillary sinusitis presents with progressive enophthalmos and hypoglobus in the absence of any symptoms of a sino-inflammatory disease. 2 Kass et al reported 22 cases of the syndrome, of which 5 had ocular signs.…”

Section: Descriptionmentioning

confidence: 99%