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39 year old male with diplopia on right gaze
Digital Journal of Ophthalmology 2001
Volume 7, Number 6
October 1, 2001
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Brad Wakeman, BSc. OC(C) | Room 2-133 Clinical Sciences Building, University of Alberta Hospital, Edmonton, Alberta, CANADA
Ian MacDonald, MDCM FRCSC | Room 2-133 Clinical Sciences Building, University of Alberta Hospital, Edmonton, Alberta, CANADA
Examination
Visual Acuity: (uncorrected) OD 20/20 OS 20/25+3

Titmus stereopsis: 40 seconds arc

Prism covertest measurements:
Distance
X6 Prism diopters

RH2 Prism diopters

(R.Gaze) XT35 PrismD RHT12 PrismD orthophoria orthophoria (L.Gaze)
Head tilt right: XT 4 PrismD RHT 2 PrismD orthophoria Head tilt left: X8 PrismD

Near X'10 PrismD

Ocular rotations: Limitation in adduction OS, worse in upgaze. Globe retraction and mild down-shoot OS on attempted adduction. Normal adducting saccades (Figure 1).

View FROM Left Side: Side gaze photos demonstrating narrowing of the palpebral fissures and globe retraction OS on gaze right (Figure 2).

Hertel expophthalmometry: Base 102 mm, OD 19 mm, OS 20 mm

Slit lamp exam: OD normal; OS old iris pigment adhesions on anterior lens capsule, anterior chamber clear and quiet, no cells or flare.

Fundus: Unremarkable OD & OS
top
Figure 1
Ocular Rotations

Figure 2
Side View

Figure 3
one month Post-op