title: "My eyes are turned outside".
abstract: A 78-year-old white woman noted progressively worsening headache, fluctuating decreased vision, dizziness, and binocular horizontal and vertical diplopia of two months duration. She had a 40 prism diopter exotropia and bilateral ophthalmoplegia. An initial temporal artery biopsy (TAB) was negative for findings of giant cell arteritis (GCA). Empiric prednisone was continued, and a second TAB was positive for GCA. In time there was complete resolution of the ophthalmoplegia.
authors.affiliation: Department of Ophthalmology, The Methodist Hospital, Houston, Texas; Department of Ophthalmology, Weill Cornell Medical College, Houston, Texas.
authors.forename: Nagham
authors.initials: N
authors.lastname: Al-Zubidi
authors.affiliation: Departments of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas; Department of Ophthalmology, Baylor College of Medicine, Houston, Texas.
authors.forename: Patricia
authors.initials: P
authors.lastname: Chevez-Barrios
authors.affiliation: Department of Ophthalmology, Baylor College of Medicine, Houston, Texas. Electronic address: foroozan@bcm.tmc.edu.
authors.forename: Rod
authors.initials: R
authors.lastname: Foroozan
authors.affiliation: Department of Ophthalmology, Duke Eye Center and Duke University Medical Center, Durham, North Carolina; Department of Neurology, Duke University Medical Center, Durham, North Carolina.
authors.forename: M Tariq
authors.initials: MT
authors.lastname: Bhatti
mesh_terms: D000368:Aged; D001706:Biopsy; D004172:Diplopia / Q000175:diagnosis* / Q000188:drug therapy; D005099:Exotropia / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D013700:Giant Cell Arteritis / Q000175:diagnosis* / Q000188:drug therapy; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D009886:Ophthalmoplegia / Q000175:diagnosis* / Q000188:drug therapy; D011241:Prednisone / Q000627:therapeutic use; D013699:Temporal Arteries / Q000473:pathology*
chemical_list: D005938:Glucocorticoids; D011241:Prednisone
keywords: diplopia; exotropia; fourth nerve palsy; giant cell arteritis; ophthalmoplegia