Heavy eye syndrome: a case report / [author]: Puertollano Punzalan, Ellore Noelle, Barja, Claire Baldovino
- Fairview, Quezon City: Department of Obstetrics & Gynecology, FEU-NRMF, 2024
- (in folder) with flash drive (soft copy)
Includes bibliographical references
ABSTRACT: This is a case of a 54-year-old female who presented with gradually decreasing vision, eye pain and inward deviation of both eyes. The attending Ophthalmologist diagnosed and managed the patient as Glaucoma, to consider Paralytic Strabismus, OU. Patient was referred to a Strabismus Specialist and was diagnosed as Heavy Eye Syndrome and was advised strabismus surgery. Pre-operative ocular examination revealed best corrected visual acuity of OD: 20/200+1 on the right eye and 20/150 on the left eye. Both eyes were esotropic and hypotropic with -4 motility in all gazes. The external eye examination for both eyes were unremarkable except for ptosis on the left upper lid. Pupils were 2-3mm briskly and equally reactive to light. Fundus findings of both eyes show (+) red-orange reflex, clear media, disc and macula cannot be well appreciated due to the position of the eye. Contrast-enhanced Orbital Cranial MRI was done which revealed bilateral medially deviated globes, with absent lens. There is supero-temporal prolapse of the globe displacing the lateral rectus interiorly and the superior rectus medially. Post-operative ocular examination revealed refraction of right eye: -5.00 sphere corrected to 20/200 vision, left eye: -5.50 sphere corrected to 20/63-2 vision. Extraocular movements on the right eye is -4 in all gazes and full and intact in the left operated eye. The external eye examination for both eyes are unremarkable with marked improvement of ptosis on left lower lid. Pupils are 2-3mm equally reactive to light. The fundus findings of right eye cannot be well appreciated due to position of the eye; The left eye shows (+) red-orange reflex, clear media, yellow-orange disc, distinct disk borders, CDR 0.4, with myopic crescent on the 6-12 o'clock of the optic disc, AVR 2:3, no hemorrhages/exudates, tessellated fundus. Supra Maximal Medial Rectus Recession (Hangback Technique) and Augmented Partial Jensen Technique done on the left eye resulted in a satisfactory alignment and return of partial abduction of left eye.