OCR Text |
Show J. Clin. Neuro-ophthalmol. 4: 69, 1984. Neuroradiological Feature Photo AHMAD M. MANSOUR, M.D. SOBHI ANTONIOS, M.D. ROBERT D. REINECKE, M.D. Computed tomography of the orbit demonstrates the eyeball position in strabismus fixus. The right eyeball is turned around 90° medially, and the cataractous lens is facing the medial wall of the orbit. The left surgically aphakic eye is turned around 30° nasally. The left optic nerve is running parallel to the lateral rectus before turning and entering the sclera. The medial recti are markedly thickened, and the lateral recti are moderately thinned. The patient is a 52-year-old diabetic man suffering from bilateral lateral gaze palsy of sudden onset during childhood. He had subsequently progressive inward deviation of the right eye as March 1984 well as progressive decrease in right visual acuity with complete loss of vision at the age of 40. Fundoscopy of the left eye revealed no evidence of diabetic retinopathy despite his severe diabetic vasculopathy. Serial sections of the right eye after enucleation revealed central retinal artery occlusion. In strabismus fixus convergens, the marked inward deviation of eyeball hampers the central retinal artery circulation at the site of exit of the optic nerve from the eye. This explains the findings of central retinal artery occlusion in the right and the absence of diabetic changes in the left eye. 69 |