A case of bilateral horizontal gaze palsy and concurrent esotropia

Mina Ghobrial; Edward Kuwera

doi:10.1016/j.ajoc.2023.101947

A case of bilateral horizontal gaze palsy and concurrent esotropia

Am J Ophthalmol Case Rep. 2023 Oct 26:32:101947. doi: 10.1016/j.ajoc.2023.101947. eCollection 2023 Dec.

Authors

Mina Ghobrial¹, Edward Kuwera²

Affiliations

¹ Medical College of Wisconsin, Department of Physiology, Milwaukee, WI, USA.
² The Johns Hopkins University School of Medicine - the Wilmer Eye Institute, Baltimore, MD, USA.

Abstract

Purpose: To report a unique case of bilateral horizontal pontine gaze palsy with concurrent esotropia, surgical management, and post-operative follow-up.

Observations: A 39-year-old male presented with diplopia and a history of neurocysticercosis. He was found to have bilateral horizontal gaze palsy and concurrent esotropia, R > L. Classic bimedial rectus recess-resect surgery was done to include resection of the right lateral rectus muscle. Follow-up three months post-op demonstrates markedly improved diplopia.

Conclusion and importance: We present a recommended therapeutic approach for the rare case of concurrent bilateral horizontal gaze palsy and esotropia, which should be further evaluated in longitudinal studies.

Keywords: Bilateral horizontal gaze palsy; Cross fixation; Esotropia; Gaze palsy; Strabismus.

Publication types

Case Reports