Acute Painful Ptosis Secondary to IgG4 Dacryoadenitis.
A 48-year-old lorry driver presented with 3 weeks of blurred vision, pain and diplopia. There was a right upper lid ptosis with some restriction of eye movements. A CT revealed an enlarged lacrimal gland and lacrimal gland biopsy showed IgG4-positive plasma cells. The patient responded to oral prednisolone and fully recovered. As a condition which mimics a number of diseases, an IgG4-related disease presents a diagnostic challenge and ought to be considered in both acute and chronic presentations.
Department of Ophthalmology, Leicester Royal Infirmary, Leicester, UK.
Rumana
R
Hussain
Department of Ophthalmology, Leicester Royal Infirmary, Leicester, UK.
Abdul
A
El-Khyat
Department of Ophthalmology, Leicester Royal Infirmary, Leicester, UK.
Antonella
A
Berry-Brincat
Dacryoadenitis; IgG4; Third nerve palsy