Paik Ji-Sun, Yang Suk-Woo, Park Shin Hae
Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-Gu, Seoul, 137-701, South Korea.
BMC Ophthalmol. 2016 Jul 22;16:119. doi: 10.1186/s12886-016-0300-7.
Cyclic strabismus is a very rare condition of ocular motility characterized by alternating strabismus and orthotropia. We report a patient with a 48-h cycle of vertical deviation associated with dysthyroid ophthalmopathy that spontaneously resolved.
A 40-year-old woman experienced sudden onset vertical double vision. She had already been diagnosed with hyperthyroidism. Asymmetric enlargement of the inferior and medial rectus muscles was demonstrated in her left eye on computed tomography, and was compatible with dysthyroid ophthalmopathy. She clearly described the "every-other-day" pattern of diplopia that spontaneously switched around 8 o'clock every night. She exhibited left hypotropia of 35 prism diopters on a bad day, and 7 prism diopters on a good day.
This case illustrates that cyclic vertical deviation may spontaneously resolve along with the course of the underlying diseases that initiated the cyclic deviation, especially in patients with conditions involving motor component changes such as dysthyroid ophthalmopathy.
周期性斜视是一种非常罕见的眼球运动疾病，其特征为交替性斜视和正视。我们报告一例与甲状腺功能异常性眼病相关的垂直偏斜呈48小时周期发作且自行缓解的患者。
一名40岁女性突然出现垂直性复视。她已被诊断为甲状腺功能亢进症。计算机断层扫描显示其左眼内直肌和下直肌不对称增大，符合甲状腺功能异常性眼病。她清晰地描述了复视的“隔日”模式，即每天晚上8点左右会自行转换。在症状严重时，她表现出左眼35棱镜度下斜视，症状较轻时为7棱镜度。
该病例表明，周期性垂直偏斜可能会随着引发周期性偏斜的基础疾病的病程发展而自行缓解，尤其是在患有涉及运动成分改变的疾病（如甲状腺功能异常性眼病）的患者中。
