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Diplopia is a rare but well recognised complication following retrobulbar and peribulbar local anaesthesia but it has not been widely reported following sub-tenon's local anaesthesia (STLA). We report on a 76-year-old woman who developed vertical diplopia after left phacoemulsification. She had received a STLA. She had left hypotropia measuring 30 prism diopters for near and distance. She was managed with occlusion but there was no improvement in her findings over 6 months. Ocular motility opinion was then sought and a presumptive diagnosis of inferior rectus fibrosis was made. She subsequently underwent a left inferior rectus recession using adjustable sutures. Postoperatively she had a residual left hypotropia measuring 8 prism dioptres and single vision. Possible causes of inferior rectus fibrosis include muscle damage during traumatic sub-tenon's block or myotoxicity due to local anaesthetic agents. This case highlights the importance of close supervision of inexperienced staff administering regional anaesthetics.  相似文献
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A 61-year-old woman with intermittent ocular irritation redness and swelling of her eyes was followed up and investigated. The diagnosis was conjunctival CD5 positive mucosa-associated lymphoid tissue (MALT) lymphoma, which is an atypical and rare type of pathology of the eye, in which the clinical course/behavior is not fully understood. Our experience showed that this disease is indolent and responds well to radiotherapy. It can recur in the fellow eye, even after as many as eight years of successful treatment with no evidence of recurrences in the previously affected eye. Therefore, long-term periodic follow-up is mandatory to detect recurrences in such patients. Further studies are also required to elucidate a more conclusive clinical behavior of this disease so that a clearer therapeutic and management plan can be devised for future patients with this disease.  相似文献
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Lacrimal-auricular-dental-digital (LADD) syndrome comprises multiple anomalies. It can be inherited as autosomal dominant with variable expressivity or can be sporadic in nature. The clinical features of LADD syndrome include variably, lacrimal system hypoplasia, ear anomalies (with or without hearing impairment), salivary system hypoplasia, epiblepharon, dry eyes, corneal limbal stem cells deficiency, hypodontia, microdontia, xerostomia, and clinodactyly. We would like to report a unique case series of LADD syndrome patients presenting with diffuse ophthalmoplegia and facial muscle dysfunction, which may be a distinct subset of LADD syndrome or a new syndrome itself. We believe this to be the first such report. We suggest careful examination of ocular movements in all newly diagnosed LADD syndrome patients.  相似文献
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