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Reading: A case of constant esotropia with diplopia associated with weight loss in anorexia nervosa

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Case Report

A case of constant esotropia with diplopia associated with weight loss in anorexia nervosa

Authors:

B. Manzouri ,

Department of Strabismus & Paediatrics, Moorfields Eye Hospital, City Road, London EC1V 2PD, GB
About B.

MRCP MRCOphth

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G. G. W. Adams

Moorfields Eye Hospital, London, GB
About G. G. W.

FRCS(Ed) FRCOphth

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Abstract

Aim: To describe the ease of a 21-year-old woman who presented with a constant esotropia with diplopia following the onset of anorexia nervosa, in whom the control of her strabismus and diplopia improved as body weight was regained.

Method: The orthoptic findings are presented and the outcome of treatment with botulinum toxin injection is reported.

Results: Botulinum toxin injection reduced the angle of deviation from 50Δ base-out (BO) for distance and 45Δ BO for near, to 30Δ BO for distance and 25Δ BO for near. After the injection the patient reported a marked improvement in symptoms and experienced diplopia only when tired. Over time and in conjunc­tion with weight gain the deviation was controlled to a microtropia with an associated latent component with demonstrable anomalous binocular vision.

Conclusion: This case shows the possible effects of anorexia on the balance of the oculomotor system, with the onset of a convergent squint at a time of severe weight loss. Botulinum toxin injection under local anaesthetic may be the wisest and least invasive therapeutic choice in these patients, thereby avoiding a surgical procedure under general anaesthesia, which may be unsuitable in cases of anorexia.
DOI: https://doi.org/10.22599/bioj.191
How to Cite: Manzouri, B. and Adams, G.G.W., 2005. A case of constant esotropia with diplopia associated with weight loss in anorexia nervosa. British and Irish Orthoptic Journal, 2, pp.50–51. DOI: http://doi.org/10.22599/bioj.191
Published on 01 Jan 2005.
Peer Reviewed

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