Abstract

A 68-year-old male patient presented with a week of sudden diplopia. He had been diagnosed with nasopharyngeal cancer 8 months prior and had undergone chemotherapy with radiotherapy. Eight-prism diopter right esotropia in the primary position and a remarkable limitation in abduction in his right eye were observed. Other pupillary disorders and lid drooping were not found. After three weeks, the marginal reflex distance 1 was 3 mm in the right eye and 5 mm in the left eye. The pupil diameter was 2.5 mm in the right eye, and 3 mm in the left eye under room illumination. Under darkened conditions, the pupil diameter was 3.5 mm in the right eye, and 5 mm in the left eye. After topical application of 0.5% apraclonidine, improvement in the right ptosis and reversal pupillary dilatation were observed. On brain magnetic resonance imaging, enhanced lesions on the right cavernous sinus, both sphenoidal sinuses, and skull base suggested the invasion of nasopharyngeal cancer. Lesions on the cavernous sinus need to be considered in cases of abducens nerve palsy and ipsilateral Horner's syndrome.

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Authors

Kang NH, Lim KH, Sung SH

Institution

Department of Ophthalmology, Ewha Womans University Mokdong Hospital, Seoul, Korea.

Source

Korean journal of ophthalmology : KJO 25:6 2011 Dec pg 459-62

MeSH

Abducens Nerve Diseases
Aged
Carcinoma, Squamous Cell
Cavernous Sinus
Combined Modality Therapy
Horner Syndrome
Humans
Magnetic Resonance Imaging
Male
Nasopharyngeal Neoplasms

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

22131787