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The Unilateral Abducens Nerve Palsy with Small Esotropia Caused by Clival Chordoma
Ann Optom Contact Lens 2021;20:43-46
Published online March 25, 2021
© 2021 The Korean Optometry & Contact Lens Study Society

Yeong A Choi, MD1, Youngbeom Seo, MD2, Won Jae Kim, MD1

Department of Ophthalmology, Yeungnam University College of Medicine1, Daegu, Korea
Department of Neurosurgery, Yeungnam University College of Medicine2, Daegu, Korea
Correspondence to: Won Jae Kim, MD
Department of Ophthalmology, Yeungnam University Hospital, #170 Hyeonchung-ro, Nam-gu, Daegu 42415, Korea
Tel: 82-53-620-4191, Fax: 82-53-626-5936
* Conflicts of Interest: The authors have no conflicts to disclose.
Received February 1, 2021; Revised February 15, 2021; Accepted February 15, 2021.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: To report a unilateral abducens nerve palsy caused by clival chordoma presenting with small angle of esotropia.
Case summary: A 66-year-old male visited our clinic with a complain of suddenly developed horizontal diplopia for 4 days. He did not report the presence of any other systemic disease. The visual acuity was 20/40 in both eyes. There was no proptosis and abnormal lid problem in either eye. The pupils showed normal response to both light and near stimulation. Extraocular examination revealed 6 prism diopters (PD) esotropia at primary gaze without definitive abduction limitation. The esotropia increased to 12 PD at the right gaze and orthotropia at the left gaze. There were no other systemic neurologic or ocular symptoms. The brain magnetic resonance imaging revealed the mass arising from the clivus compressing the pontine area and the right abducens nerve. He was consulted to neurosurgery department for surgical treatment of mass. The removal of tumor using endoscopic endonasal transclival approach was performed. The pathologic report confirmed the chordoma. At 1 month after the surgery, there was no diplopia. He showed orthotropia at primary and both lateral gaze.
Conclusions: The small angle of esotropia can be only presenting sign of abducens nerve palsy caused by clival chordoma. The strabismus and diplopia can be improved with surgical treatment.
Keywords : Abducens nerve palsy; Chordoma; Cranial fossa

March 2021, 20 (1)