To the Editor.
—In the January 1988 issue of the Archives, Dr Kushner1 reported an interesting but atypical diplopia in a 73-year-old woman which he described as "an unusual case of acquired ocular muscle fibrosis after cataract surgery."While not anxious to deprive the medical world of the "Kushner syndrome," I am anxious to avoid this causative implication of cataract surgery and diplopia in a woman with enlarged ocular muscles and restriction of elevation that began "several weeks after surgery" and progressed "during the subsequent months."Until proved otherwise, this picture is most suggestive of euthyroid Graves' disease or "dysthyroid" orbital myopathy. Her age, signs, symptoms, laboratory results, computed tomographic scan, and clinical course were compatible with, and characteristic of, patients with this diagnosis. To suggest that such a multifocal, posterior orbital hypertrophic myopathy is due to a delayed response to the surgery or to local anesthesia is to
Martin Lubow. Dr Kushner's Unneeded Syndrome. Arch Ophthalmol. 1988;106(9):1162. doi:10.1001/archopht.1988.01060140322003