Zhang Jia Jia, Nguyen Michael T B, Gaier Eric D
Harvard Medical School, Boston, Massachusetts.
Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology, Boston Children's Hospital, Boston, Massachusetts.
J AAPOS. 2025 Feb;29(1):104096. doi: 10.1016/j.jaapos.2024.104096. Epub 2024 Dec 31.
A man in his 60s developed an intermittent, variable left hypotropia with symptomatic diplopia following nasal pterygium surgery in the left eye. No tropia was present for most of the day, but a variable left hypotropia of 25 could be provoked with downgaze. There was no history of radiation or other trauma. Magnetic resonance imaging of the brain and orbits with gadolinium was unremarkable. The patient was diagnosed with suspected ocular neuromyotonia secondary to the peribulbar block and temporarily managed with Fresnel prism. A trial of oral carbamazepine partially improved symptoms. He ultimately underwent a left inferior rectus recession with near complete resolution of his symptoms.
一名60多岁男性在左眼鼻侧翼状胬肉手术后出现间歇性、可变的左眼上斜视，并伴有症状性复视。一天中的大部分时间没有斜视，但向下注视时可诱发25棱镜度可变的左眼上斜视。无放疗或其他外伤史。头颅和眼眶钆增强磁共振成像未见异常。该患者被诊断为疑似球周阻滞继发的眼肌阵挛，暂时用菲涅耳棱镜处理。口服卡马西平试验部分改善了症状。他最终接受了左眼下直肌后徙术，症状几乎完全缓解。
