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31 year old woman with vertical diplopia for 2 months
Digital Journal of Ophthalmology 1998
Volume 4, Number 21
August 8, 1998
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Kenneth Graham, MD | Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
Examination
Vision: 16/15 OU
Color plates: 10/10 OU
Pupils: OD 4 --> 2 OU, no afferent pupillary defect
Motility: full ductions and versions OU, cover test: exotropia of 8 prism diopters in all directions of gaze.
Neurological Exam: Cranial nerves 1-12 intact
External Exam: see Figure 1
Slit Lamp Exam: anterior segments normal OU, tonometry normal OU
Dilated Fundus Exam: disk, vessels, macula, and periphery normal OU
Goldmann Visual Fields: see Figures 2-3
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Figure 1
External photographs of the patient showing right exotropia when the left eye is fixating

Figure 2
Figures 2-3. Goldman visual fields OU showing dense temporal field loss respecting the vertical midline.

Figure 3