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November 1965

Alternating Exophthalmos With Painful Ophthalmoplegia

Author Affiliations

From the Wills Eye Hospital and the Pennsylvania Hospital.

Arch Ophthalmol. 1965;74(5):625-627. doi:10.1001/archopht.1965.00970040627008

A patient is presented with alternating unilateral exophthalmos associated with severe cephalalgia and ophthalmoplegia. Over a seven-year period, six episodes were equally distributed between right and left. He is being presented with such a combination of clinical findings to emphasize the possibility that an alternating unilateral cephalalgia of vascular origin may cause orbital swelling sufficient to produce exophthalmos.

Report of Case  The patient, a 24-year-old seminary student, was referred to the author by Dr. Fred Laschever of Princeton, NJ. Seven years prior to his present illness he began to experience episodes of unilateral cephalalgia involving alternately the right and left side accompanied by ptosis and double vision. The initial three attacks were less severe than the last three, but each one would last from 10 to 12 days. With one of the initial episodes, the patient was investigated as to neurological examination, lumbar puncture, and x-rays of the skull, all