DR. S.AISHA RAZA

Dr. ANAM MASOOD, DR. S.AISHA RAZA

Abstract

A 10 year old female presented with drooping of right upper lid with inward deviation and inability to elevate RE since birth. Birth and developmental history were normal. The BCVA in RE was +2.0DS/+0.5DC180 6/9 and in LE +0.50DC180 6/6. Bruckner’s reflex was brighter in RE. Slit lamp examination and fundus examination was within normal limits in BE. On squint evaluation PBCT for near and distance was – RET 50PD RHoT 45PD. RE suppression on BSG. She was lost to follow-up. 3 months later she presented with BCVA in RE +2.75DS/+0.50DC180 6/36 and LE +0.50DC180 6/6. The PBCT for near and distance was RET 60PD RHoT 45PD. On FDT there was limitation in elevation above midline and limitation in extreme abduction. FGT was normal. Upward saccade present till midline. In RE Bell’s phenomenon was absent and Marcus gunn jaw winking was present. On ptosis evaluation of RE MRD1 was -3mm, LPS action was 0mm with no lid lag. She was planned for IR RCN 6mm, MR RCN 6.5mm and LR plication 9 mm.