[Skip to Navigation]
Views 688
Citations 0
JAMA Ophthalmology Clinical Challenge
October 7, 2021

Diplopia, Ptosis, and Drooling in an 80-Year-Old Woman

Author Affiliations
  • 1Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
  • 2Department of Neurology, University of Toronto, Toronto, Ontario, Canada
JAMA Ophthalmol. Published online October 7, 2021. doi:10.1001/jamaophthalmol.2021.0691

An 80-year-old woman presented to the emergency department with sudden-onset bilateral horizontal diplopia accompanied by left-sided upper eyelid ptosis. On further questioning, she reported a 1-week history of drooling when eating. She had no other associated neurological or constitutional symptoms. No anhidrosis was noted. Her medical history was significant for a 2-year history of constant, dull, left-sided facial pain diagnosed as trigeminal neuralgia by her treating neurologist and moderately improved with gabapentin and nortriptyline. Recent computed tomography (CT) of the brain, conducted as part of her headache workup, had been reported as normal.

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    ×