Binocular Diplopia as a Rare Late Complication of Conjunctivoplasty Surgery for Conjunctival Chalasis

Conjunctival chalasis is characterized by excess conjunctival membrane that may cause pain, dryness, and other ocular surface pathology. Conjunctival surgery may be indicated for treatment of symptomatic cases. We present a case of late onset binocular diplopia as a result of corneal conjunctival adhesion due to radiofrequency ablation of conjunctival chalasis.

Poster 166 Binocular diplopia as a rare late complication of conjunctivoplasty surgery for conjunctival chalasis Emma Wolinsky1, Kevin Sitko1 1 University of New Mexico, Albuquerque, New Mexico, USA Introduction: Conjunctival chalasis is characterized by excess conjunctival membrane that may cause pain, dryness, and other ocular surface pathology. Conjunctival surgery may be indicated for treatment of symptomatic cases. We present a case of late onset binocular diplopia as a result of corneal conjunctival adhesion due to radiofrequency ablation of conjunctival chalasis. Description of Case(s): A 70-year-old woman with symptoms of dry eyes was found to have significant conjunctival chalasis by an outside cornea specialist. She was treated conservatively with plugs and topical ocular cyclosporine for a short time before conjunctivoplasty was recommended on the right eye. Approximately one year after surgery she developed intermittent binocular diplopia. At presentation she had visual acuities of 20/30 in each eye. Ocular motility suggested a mild limitation of right eye abduction but was otherwise full. Cover testing and Maddox rod testing revealed a mild esophoria in primary gaze worsening in right lateral gaze and resolving in left gaze. A mild left hyperphoria was present only in gaze up and to the right. Slit lamp exam revealed a pseudopterygium extending onto the inferonasal cornea as a result of conjunctivocorneal scarring. Conclusions, including unique features of the case(s): Ocular surface surgeries are a rare cause of binocular diplopia due to a restrictive process. We could find no reports of binocular diplopia secondary to conjunctivoplasty for conjunctival chalasis. However, the correlation between the slit lamp corneal findings and the pattern of ocular misalignment as measured by cover testing in this patient confirmed the cause of the ocular misalignment to the exclusion of other pathologies. As such, costly and unnecessary neuroimaging was avoided by early pattern recognition. The late onset of diplopia in this case argues for progression of conjunctivo-corneal scarring. References: None. Keywords: ocular motility, eyelid & adnexal disease, Adult strabismus with a focus on diplopia Financial Disclosures: The authors had no disclosures. Grant Support: None. Contact Information: Kevin Sitko, [e-mail] 2022 Annual Meeting Syllabus | 229