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Lees chart demonstrating lateral rectus restriction and bilateral underactions of the superior obliques. 

Lees chart demonstrating lateral rectus restriction and bilateral underactions of the superior obliques. 

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Aim: To report a case of sudden-onset diplopia, blurred vision and an inability of the left eye to fully abduct following trauma. Subsequent examinations showed significant variability leading to a possible diagnosis of myasthenia gravis. Methods: This is a case report of a 7-year-old boy with a 2-day history of blurred vision, horizontal diplopia...

Context in source publication

Context 1
... patient's vision was good either eye, with right being 6/7.5 þ 2 and left 6/7.5 þ 1, but cover test revealed a moderate left esotropia with diplopia measuring 35-40 D BO (prism dioptres) for near and 45 D BO for distance. Ocular motility revealed a slight restriction of the lateral rectus of the left eye, and also slight underaction of the left inferior oblique and equal overaction of the right superior rectus. A Lees chart was performed which demonstrated the lateral rectus restric- tion with full muscle sequelae and also bilateral under- actions of the superior oblique ( Fig. 1) which had not been noted on ocular motility ...