Dr.SREELAKSHMI S

Dr.Teena Mariet Mendonca, Dr.Gladys R Rodrigues, Dr.SHOBHA G. PAI

Abstract

Internuclear ophthalmoplegia is an ocular movement disorder caused by a lesion at Medial longitudinal fasiculus. Usually caused by multiple sclerosis with trauma being a rare cause. A 46year old male patient was referred by a local doctor for limitations of eye movements in Right eye. Patient sustained head trauma with loss of consciousness following automobile accident 20 days back. He had no visual complaints, diplopia or headache on presentation. On examination his BCVA was 6/6 in both eyes. He was orthophoric in primary gaze. Ocular motility examination revealed adduction deficit in the Right eye and nystagmus in the Left eye on leftward gaze and normal convergence. Pupillary reactions and fundus examination were normal. CT scan showed petechial haemorrhage in midbrain with diffuse brain edema. A diagnosis of Right post traumatic internuclear ophthalmoplegia was made and was treated conservatively. He showed spontaneous improvement in 2 weeks.