DR. JAISRIPRIYA ARUMUGAM

DR. KOWSALYA AKKAYASAMY

Abstract

A 11 year old girl child presented with binocular double vision for 3days. Past history of fever and headache was present. BE BCVA 6/6. On examination small esotropia in LE with abduction restriction was noted . Anterior segment and fundus examination were normal. LE sixth nerve palsy was confirmed by Hess and Diplopia chart. MRI Brain and skull base revealed Right sided nasal and parapharyngeal abscess with extension into pterygopalantine fossa, cavernous sinus, dorello’s and meckel’s canal with encasement of 5,6th cranial nerves. CT thorax showed lung infiltration with possibility of tuberculosis. Patient was referred to neurologist for further management and was started on ATT . We report this case where in the sixth nerve palsy was due to an infectious etiology in a child and its ocular manifestation lead to the diagnosis of an un recognised systemic illness.