This 74-year-old male presents with a 2-month history of intermittent diplopia and ptosis of the left eye. Both eyes have limited elevation and the left eye has moderately limited abduction. A 25 PD esotropia and 10 PD left hypotropia are present. Pupils are equal. He reports that he is better in the morning and worse as the day goes on. He has undergone bilateral cataract surgery with IOL several years ago but is otherwise without any significant ocular history. What could be happening?
6 thoughts on “Quiz: 2-Month History of Intermittent Diplopia & Ptosis”
Left 3rd nerve palsy
A very good question, for critical thinking
Very educative, thank you very much
This is a magnificent gesture to reflect you knowledge
There is a small error in the text. See insert below:
“While a partial third nerve palsy could give you ptosis and strabismus, it would not cause an esotropia or adduction deficit (more likely to be exotropic and have an abduction deficit).”
I think you mean it would not cause an esotropia or abduction deficit (more likely to be exotopic and have an adduction deficit).
You are absolutely correct! Thank you for catching my transposition! We have made the edit to the quiz.