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August 1986

Abduction Deficit Secondary to Presumed Bacterial Dacryoadenitis

Arch Ophthalmol. 1986;104(8):1127-1128. doi:10.1001/archopht.1986.01050200033027

To the Editor.  —Causes of abduction deficits include various congenital and acquired syndromes of the extraocular muscles and the sixth cranial nerve. We describe a patient with an abduction deficit secondary to a presumed, spontaneous bacterial dacryoadenitis that responded promptly to appropriate intravenous antibiotics.

Report of a Case.  —A 20-year-old woman developed discomfort on right gaze, and mild right upper eyelid swelling, which was initially treated with topical vasocidin. During the next two days as the pain increased and a mucopurulent discharge developed, she experienced horizontal binocular diplopia worse on right gaze. Naphazoline hydrochloride (Naphcon-A) and erythromycin (Ilotycin) therapy was started and the patient was referred to our unit.Uncorrected visual acuity was 20/30 bilaterally. Right upper eyelid edema, erythema, ptosis, and a mucopurulent discharge were present in association with an abduction deficit of the right eye (Fig 1). No predisposing skin lesions or signs of local trauma were found.