Internal ophthalmoplegia after retinal laser photocoagulation.

AIM

To report the clinical presentation and course of internal ophthalmoplegia after retinal laser photocoagulation in three patients.

METHODS

We report three cases in which internal ophthalmoplegia occurred after retinal laser photocoagulation. All patients underwent detailed clinical examination and anterior segment and fundus photography. Denervation supersensitivity testing with 0.125% pilocarpine was done in two cases. Pupil graphs were recorded in third case at presentation and at follow up.

RESULTS

All three cases showed dilated pupils with loss of accommodation after undergoing retinal photocoagulation, of which two cases were documented to have denervation supersensitivity. On follow up, one case showed complete accommodation recovery and partial pupil recovery over a follow up of 10 months. Another case nearing presbyopic age had no recovery in accommodation and had partial pupil recovery after 20 months.

CONCLUSION

Isolated internal ophthalmoplegia is a rare complication of retinal laser photocoagulation. It has been reported to be a transient phenomenon. Our case series shows the slow recovery pattern with only partial recovery until a follow up of 20 months, documented by pupil graphs.