J Korean Ophthalmol Soc.  2009 May;50(5):804-807. 10.3341/jkos.2009.50.5.804.

A Case of Convergence Spasm After Head Trauma

• Lee YH
• Lee EK
• Yun YJ
• Lee SB

• KMID: 2212329
• DOI: http://doi.org/10.3341/jkos.2009.50.5.804

Abstract

PURPOSE:We report a case of convergence spasm that occurred after head trauma.
CASE SUMMARY
A 18-year-old female presented with intermittent diplopia and decreased vision shortly after head trauma. Her past medical history was non-specific, except myopia in the left eye. On the initial examination, her uncorrected visual acuity and was variable (0.1~1.2 in the right eye, 0.05~0.1 in the left), but the corrected visual acuity was 1.2 in both eyes. Manifested refraction was also variable (-0.50~-5.50 diopters (D) in the right eye, -4.50~-6.50D in the left eye). Cycloplegic refraction was -0.50D in the right eye, and -4.50D in the left eye. The patient showed a variable esotropia (4~16 prism diopters (PD) at distance, 4~30PD at near). There was no limitation on abduction. There was no abnormality in the brain MRI. Five months after the initial visit, diplopia and blurred vision persisted.

Keyword

Convergence spasm; Diplopia; Head trauma

MeSH Terms

Adolescent
Brain
Craniocerebral Trauma
Diplopia
Esotropia
Eye
Female
Head
Humans
Myopia
Spasm
Vision, Ocular
Visual Acuity

Figure

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  Figure 1. Composite photograph of nine-cardinal gaze at 1 day after head trauma: It shows a right esotropia of 30 prism diopters in primary position and no significant limitation in abduction.

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  Figure 2. (A), (B) T1 and T2 weighted magnetic resonance imaging scans did not show any abnormal signal intensity in the midbrain.

Reference

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