Clinical Professor, Department of Ophthalmology, Weill Cornell Medicine, New York City, New York
Subject
Third Nerve Palsy; Third Nerve Paresis; Relative Afferent Pupillary Defect (RAPD); Papilledema
Description
17 year old woman with ptosis and diplopia. Limitation is very subtle. Shows a cover cross cover testing. Left gaze XT and LH; right gaze ET. Shows a Maddox rod which confirms subtle third nerve. Shows measuring of the pupils for anisocoria, then measuring an RAPD. Left pupil has RAPD; right pupil is larger. Patient shown turning head side to side. She has subtle right third nerve paresis involving pupil, bilateral 6th nerve paresis, left drift with weakness of left seventh nerve. She has a left visual field defect and a small left RAPD and chronic subtle papilledema.
