A Rare Cause of Diplopia: Functional Near Reflex Spasm

Abstract

Introduction: Many serious neurological and ophthalmological diseases are reported in patients presenting to the emergency service with the complaint of diplopia. Near reflex spasm is a rare cause of diplopia, which may mimic abducens nerve palsy. Case Report: A 27-year-old female presented to the emergency service with the complaint of diplopia and blurred vision. There was no drug usage or exposure to toxic substances. In the physical examination, convergent strabismus was observed and the pupils were miotic. Ciliary spasm was detected in the ophthalmologic examination. The results of the examinations for organic etiologies were negative. The patient recovered after the application of cycloplegic drops and the arrangement of treatment after psychiatric examinations. Conclusion: Considering near reflex spasm in patients presenting with diplopia could save the emergency services, where time is important, from unnecessary further examinations. It should not be forgotten to pay attention to miosis because it is the most important clue evocative of this rare disease.