Korean Journal of Optometry and Vision Science 2009;8(2):61-65.
Published online December 30, 2009.
하시모토 갑상샘염 환자에서 구후마취 후 발생한 수직 사시
이연희, 이은경, 남기엽, 김정열
1Department of Ophthalmology, Chungnam National University College of Medicine, 2Research Institute for Medical Sciences, Chungnam National University College of Medicine, Daejeon, Korea
Vertical Strabismus after Retrobulbar Anesthesia in Hashimoto Thyroiditis Patient
Yeon Hee Lee, Eun Kyoung Lee, Ki Yup Nam, Jung Yeul Kim
Abstract
Purpose
We report a case of vertical strabismus after retrobulbar anesthesia. We diagnosed the patient as Hashimoto's thyroiditis and observed the progression of vertical strabismus. Methods: A 33-year-old man with no history of strabismus underwent intraocular surgery under retrobulbar anesthesia in both eyes. Ocular exam including a prism test, orbital CT, thyroid function test and thyroid autoantibodies testwere performed. Results: At first visit, vertical diplopia and right hypertropia in the primary position with underaction of left inferior rectus muscle was noted. It changed to orthotropia in the primary position, and progressed to right hypotropia 2 months later. Orbital CT demonstrated a thickening of the right inferior rectus muscle belly. Thyroid function testwas normal, but thyroid autoantibodies test demonstrated very high titer of anti- thyroglobulin and anti-TPO Ab. He was consulted to endocrinologic department and diagnosed to Hashimoto's thyroiditis. Initially, He showed paretic feature of the inferior rectus muscle. The feature reversed and became restrictive, and then it became restrictive and overactive. Conclusions: In the case of vertical strabismus after retrobulbar anesthesia, Hashimoto's thyroiditis should be considered as causative factor. Thyroid autoantibodies test as well as thyroid function test may require to confirm Hashimoto's tjyroiditis. (Korean J Optom Vis Sci 2009;8(2):61-65)
Key Words: Hashimoto's thyroiditis, Retrobulbar anesthesia, Vertical strabismus
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