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September 1989

Guillain-Barré Syndrome Presenting as a Paralysis of Accommodation

Author Affiliations

Newark, NJ

Arch Ophthalmol. 1989;107(9):1282. doi:10.1001/archopht.1989.01070020352010

To the Editor.  —We report a case of a young child with an eventually confirmed diagnosis of Guillain-Barré syndrome, who presented with paralysis of accommodation as the initial finding.

Report of a Case.  —Our patient was a 7-year-old boy who presented to his pediatrician with the complaint of blurred vision and headache over a 3-day period. The patient was referred to an ophthalmologist because of his visual complaints.On examination, the child was found to have 20/60 visual acuity OU at distance and near visual acuity of J16. The near point of accommodation was appreciably lengthened and was not measured quantitatively because of severe blurring. Manifest refraction based on undilated retinoscopy showed an equivalent result to the cycloplegic retinoscopy +2.00 OD and +1.50 +.50 × 90 OS. This correction improved the patient's distance visual acuity to 20/20 in both the cycloplegic and noncycloplegic states. An addition of +3.00 diopters of

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