DR. VINODINI RAJENDRAN

DR. SRAVANA BHAVA BALACHANDRACHARI, DR. K. EZHIL VENDHAN, DR. B. JAYAPRAKASH

Abstract

A 27 year old male came with the complaints of headache since 10 years and Double vision and drooping of left eye since 6 months. On examination visual acuity was 6/6 in right eye and 6/18 with no improvement in pinhole. In primary gaze right eyeball was normal, left eyeball was displaced downward and outward . Extraocular movements was full in right eye but left eye showed right and upward restriction . Visual field was intact in right eye , left eye had extreme nasal restriction due to the abducted left eye. anterior segment – right eye within normal limits.left eye pupil was dilated about 6mm, fixed ,not reacting to light .dilated fundus examination revealed disc and vessels normal in both eyes. MRI brain revealed thin walled cystic lesion in left side interpeduncular cistern and crural cistern which is a arachnoid cyst splaying the cisternal segment of oculmotor nerve . Arachnoid cyst compressing the oculomotor nerve leading to complete oculomotor nerve palsy is rarest .