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August 1981

Metastatic Adenocarcinoma From the Stomach to the Orbit

Author Affiliations

New Hyde Park, NY

Arch Ophthalmol. 1981;99(8):1469. doi:10.1001/archopht.1981.03930020343033

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To the Editor.  —I would like to report an unusual ophthalmologic clue to a distant primary condition.

Report of a Case.  —A 33-year-old woman was seen on March 3, 1980, when she complained of diplopia and incidental dysphagia. She had had normal delivery of her second child three months before. On examination, she showed left esotropia, with complete limitation to the midline of her left eye. There was no inward limitation, while up and down motion was mildly compromised. Visual acuity was 20/20 in each eye, and pupillary actions were normal. There was no exophthalmos. The fundi were equally normal. Fields showed a defect that, later, could not be duplicated. Since she had swallowing problems, and I could not account for her paretic left lateral rectus muscle, I sought neurologic consultation. David Biddle, MD, performed a Tensilon test, the results of which were questionably positive. He could not reproduce any

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