Dr. Madhurima Vishnubhotla

Dr. RAMAN YENUGANDULA

Abstract

A 20yr old male patient came to squint opd with chief c/o headache&fever since10days &double vision since 7days.On examination vision was BE 6/6,LE esotropia of 20degrees,BE moved outward to take fixation with redressal of RE being faster than LE on alternate cover test.Abduction limitation in BE was noted.Stereopsis was poor.Diplopia chart showed uncrossed diplopia with increased separation of double images in all gazes.Hess chart showed BE lateral rectus palsy&confirmed with negative forced duction test.Fundus showed BE papilledema.MRI brain showed hyperintense signals in left sigmoid sinus.MR venography showed B/L transverse and sigmoid sinus thrombosis.Patient was put on oral anticoagulant by neurophysician.4th month followup showed reduction in diplopia and LE esotropia to 7degrees and improvement in abduction of BE.Here B/L papilledema&B/L abducens palsy were signs of raised ICT.Timely and effective anticoagulant therapy contributed to venous recanalisation and good outcome.