A 26-year-old woman who at her 29th week of pregnancy was referred from another center to our clinic for diplopia.
She had no history of diabetes, hypertension or trauma or previous strabismus.
His uncorrected visual acuity was 1 in both eyes.
Ocular motility examination showed alternating and intermittent endodeviation of 45 PD in primary position.
In the lateroscopes, a minimal limitation is suspected in the allocation of its right eye, which is not objectified in the examination by means of the Pantalla de lateroversion.
The rest of the neurological examination and examination were normal.
1.
The patient returned to our clinic 6 months later.
The motor examination showed no changes but visual acuity decreased to 0.1 in both eyes.
Its refraction with and without cycloplegia is -6 and +1 diopters respectively in both eyes.
However, the best corrected visual acuity in both cases does not exceed 0.4 in both eyes.
Ocular deviation does not change under cycloplegia.
The BainiÆs crystalline test shows normal correspondence, the Worth test does not show suppression and the TNO test is negative.
The VEP and Path were normal.
The clinical and radiological study was negative for neurological processes, Myasthenia Gravis/Eaton-Lambert and congenital myopathies.
The psychiatric examination revealed that the patient suffered an income neurosis that had triggered pregnancy.
Visual acuity was re-examined with screening methods related to the distance to the optotypes and their size, and the responses of the patient were inconsistent.
Computerized campimetry showed concentric restriction of the visual field in both eyes.
With these data amblyopia hysteria was diagnosed (1).
Botulinum toxin treatment was performed in both middle rectums, with a minimum effect for 1 month.
We believe that this result was due to a low paretic response of the toxin and although the patient was proposed, she refused a retreatment with botulinum toxin as well as surgery.
