It ’s Not Your Eyes

A 55-year-old woman reported blurred vision while walking, numbness and tingling, contact allodynia, and gait imbalance. Visual acuity was 20/20 in both eyes, but there was a loss of 4 lines with horizontal dynamic visual acuity testing. Ocular motility examination demonstrated spontaneous downbeat nystagmus that increased in lateral gaze with a torsional component and impaired smooth pursuits. Head impulse test was positive, and electromyography demonstrated a sensory neuropathy/neuronopathy. Vestibular testing confirmed both central ocular motor pathway and bilateral peripheral vestibular system involvement.

Source: Survey of Ophthalmology - April 18, 2019 Category: Opthalmology Authors: Devon A. Cohen, M. Tariq Bhatti, John J. Chen, Michelle L. Mauermann, Daniel R. Gold Tags: Clinical challenges Source Type: research