DR. SASIKALA ELIZBETH ANILKUMAR

Abstract

10 year old boy presented with abnormal movement of the right upper eye lid while chewing food since birth. Child had UCVA of 6/6 BE. External examination showed no evidence of ptosis. Anterior and fundus examination were normal. Orthoptic evaluation did not reveal strabismus. On chewing food abnormal right upper lid retraction was noted and aggravated during down gaze. A diagnosis of congenital Marcus gunn jaw winking(MGJW) in the absence of ptosis was made. Such Isolated MGJW is reported sparsely in the literature except for 19 cases till date through 3 case series and reporting an incidence of 6% among all cases of MGJW. This is due to miswiring between the branches of the trigeminal nerve supplying the internal or external pterygoids muscles of mastication & the branches of the oculomotor nerve supplying the LPS muscle. Our case is unique as none of the reported cases have an associated upper lid retraction in primary as well as down gaze during mastication as an isolated MGJW.