Paralysis of the extra-ocular muscles is a condition very rare in lead-poisoning. I recall seeing it in only one other case, that of a male attendant at the East Oklahoma Hospital for the Insane. He had to give up his work as a painter several years previously on account of his illness. When I examined him he had, as residual signs of the disease, a partial double wrist-drop and bilateral ptosis, more complete on one side, on which side also the internal rectus muscle was partially paralyzed, sufficiently so to interfere with his accommodation.
In the present case in addition to the paralysis of the right external rectus there were unusually widespread and intense atrophic muscle-changes and absence of basophilic degeneration and of the characteristic lead-line on the gums.
While the external rectus was only partially paralyzed, the paralysis was sufficient to cause double vision when the patient worked in
WILLIAMS EM. LEAD-POISONING WITH PARALYSIS OF THE EXTERNAL OCULAR MUSCLES. JAMA. 1914;LXIII(5):403. doi:10.1001/jama.1914.02570050039012