A Case of Convergence Spasm After Head Trauma

Yeon Hee Lee; Eun Kyoung Lee; Yong Jun Yun; Sung Bok Lee

doi:10.3341/jkos.2009.50.5.804

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Lee, Lee, Yun, and Lee: A Case of Convergence Spasm After Head Trauma

Original Article

J Korean Ophthalmol Soc 2009;50(5):804-807.

Published online: 7 September 2009

DOI: https://doi.org/10.3341/jkos.2009.50.5.804

A Case of Convergence Spasm After Head Trauma

Yeon Hee Lee, MD^1,², Eun Kyoung Lee, MD¹, Yong Jun Yun, MD¹, Sung Bok Lee, MD, PhD^1,²

¹Department of Ophthalmology, College of Medicine, Chungnam National University, Daejeon, Korea

²Department of Ophthalmology, Chungnam National University Research Institute for Medical Sciences, Daejeon, Korea

Address reprint requests to Sung Bok Lee, MD, PhD Department of Ophthalmology, Chungnam National Hospital #640 Daesa-dong, Jung-gu, Daejeon 301-721, Korea Tel: 82-42-280-7608, Fax: 82-42-255-3745, E-mail: sblee@cnu.ac.kr

Received 25 August 2008 Accepted 23 December 2008

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We report a case of convergence spasm that occurred after head trauma.

Case summary

A 18-year-old female presented with intermittent diplopia and decreased vision shortly after head trauma. Her past medical history was non-specific, except myopia in the left eye. On the initial examination, her uncorrected visual acuity and was variable (0.1∼1.2 in the right eye, 0.05∼0.1 in the left), but the corrected visual acuity was 1.2 in both eyes. Manifested refraction was also variable (−0.50∼-5.50 diopters (D) in the right eye, −4.50∼-6.50D in the left eye). Cycloplegic refraction was −0.50D in the right eye, and −4.50D in the left eye. The patient showed a variable esotropia (4∼16 prism diopters (PD) at distance, 4∼30PD at near). There was no limitation on abduction. There was no abnormality in the brain MRI. Five months after the initial visit, diplopia and blurred vision persisted.

Keywords: Convergence spasm, Diplopia, Head trauma

References

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Figure 1.

Composite photograph of nine-cardinal gaze at 1 day after head trauma: It shows a right esotropia of 30 prism diopters in primary position and no significant limitation in abduction.

Figure 2.

(A), (B) T1 and T2 weighted magnetic resonance imaging scans did not show any abnormal signal intensity in the midbrain.

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