A 25-year-old woman was referred to the neuro-ophthalmology clinic because of a 6-month history of intermittent diplopia. The double vision occurred every day, multiple times throughout the day, and was provoked after looking to the right. There was no eye pain, headache, ptosis, difficulties swallowing, change in voice, or any other ocular or neurological symptoms.
She had no history of strabismus, eye patching, or ocular surgery. Her medical history was notable for a growth hormone–producing pituitary macroadenoma for which she underwent surgical resection 2.5 years prior to presentation, followed by γ-knife radiosurgery (50 Gy) 6 months after the initial surgical procedure. She also had a history of congenital hip dysplasia. Medications included cabergoline, levothyroxine, ethinyl estradiol/drospirenone, and pasireotide.
Grosinger A, Chen JJ, Bhatti MT. Gaze-Provoked Exotropia in a Young Woman. JAMA Ophthalmol. 2019;137(7):840–841. doi:10.1001/jamaophthalmol.2019.1091
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