Dr.MONISHA MOHAN
Brief History
A 32 year old female with A/H/O snake bite to the right foot following which she developed sudden onset painless gross diminution of vision in the right eye associated with ptosis and external ophthalmoplegia (incomplete type) in both eyes.
Relevant treatment history
She received a total of 260 ml of ASV. She was started on Inj. Enoxaparin 0.5 ml BD for 5 days along with aspirin for possible benefit in CRAO.
Ocular Examination
On ocular examination, her ptosis and extraocular movements improved, but her vision remained denying perception of light associated with grade 3 relative afferent pupillary defect(RAPD). Fundus examination revealed central retinal artery occlusion with a cherry red spot with narrowing of arteries with retinal edema in RE and left eye revealed normal fundus. Ocular examination of LE showed Grade 1RAPD.
Provisional Diagnosis
RE Central Retinal Artery Occlusion with (BE) External Ophthalmoplegia with Ptosis.
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