Although her cough was effectively treated and intracranial pressure measurement was normal, her ophthalmic symptoms continued to progress, which is common in previous cases reported.

We report the first case of midbrain keyhole aqueduct syndrome with ocular motor and other neuro-ophthalmic manifestations associated with severe cough. Her nystagmus and diplopia improved with oral acetazolamide treatment, at high doses of 2500-3000 mg per day. Brain magnetic resonance imaging showed a 1.5â€¯mmâ€¯Ã-â€¯11.7â€¯mmâ€¯Ã-â€¯6â€¯mmâ€¯midline cleft in the ventral midbrain communicating with the cerebral aqueduct, consistent with keyhole aqueduct syndrome. She also had a right-sided ptosis and a 3 mm anisocoria not due to cranial nerve 3 paresis or Horner's syndrome. There was an incomitant left hypertropia due to skew deviation that worsened with right and up gazes and improved with down gaze. Gaze evoked nystagmus and mild paresis were also seen with up gaze. Examination revealed a 1-2 Hz down-beating nystagmus in primary gaze that worsened with left, right, and down gazes. A 58-year-old woman with a 2-year history of daily, severe cough presented to the neuro-ophthalmology clinic with progressive diplopia and oscillopsia. We report a rare case of keyhole aqueduct syndrome presenting after two years of severe cough due to gastroesophageal reflux disease. Midline structural defects in the neural axis can give rise to neuro-ophthalmic symptoms. Oh, Angela Jinsook Lanzman, Bryan Alexander Liao, Yaping Joyce Vertical diplopia and oscillopsia due to midbrain keyhole aqueduct syndrome associated with severe cough. Â© 2015 Board of regents of the University of Wisconsin System, American Orthoptic Journal, Volume 65, 2015, ISSN 0065-955X, E-ISSN 1553-4448. This paper reviews the pathophysiology of macular diplopia, describes the binocular pathology causing the diplopia, discusses the clinical evaluation, and reviews the present treatments including some newer treatment techniques. The effect that the maculopathies have on the interaction of central sensory fusion and peripheral fusion are different than the usual understanding of treatment for diplopia. Maculopathies affect point-to-point foveal correspondence causing diplopia. Shippman, Sara Cohen, Kenneth R Heiser, Larissa In this article, we present a case of horizontal diplopia following cosmetic upper blepharoplasty we review the literature on this unexpected complication and offer some recommendations to avoid it. Most of the cases are in its vertical form due to trauma of the extraocular muscles. Horizontal Diplopia Following Upper Blepharoplastyįull Text Available Diplopia is an infrequent complication after blepharoplasty. Here, we present a 57-year-old man with binocular horizontal diplopia that occurred during left direction gaze due to dacryops. Diplopia due to dacryops has not been reported previously. It is known that it can cause globe displacement, motility restriction, and proptosis because of the mass effect. Submitted comments are subject to editing and editor review prior to posting.Directory of Open Access Journals (Sweden)įull Text Available Dacryops is a lacrimal ductal cyst.Read any comments already posted on the article prior to submission. Submit only on articles published within 6 months of issue date.(Exception: original author replies can include all original authors of the article) Submissions should not have more than 5 authors.Reference 1 must be the article on which you are commenting. Submissions must be You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid If you are responding to a comment that was written about an article you originally authored: Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment. You must have updated your disclosures within six months: If you are uploading a letter concerning an article:

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