Abstract

A 64 year old male came to the Ophthalmology OPD with complaints of inability to look up and down since 3 months immediately following a history Cerebrovascular accident. he also complaints of binocular diplopia since then. H/O loss of consciousness + for about 3-5minutes. He is a known case of diabetes mellitus , coronary artery disease , pulmonary edema, cardiac failure on regular medications. On examination Visul acuity was 6/12 in both eyes with a myopic refractive error. Restricted elevation and depression in both eyes.. Vestibular ocular reflex is preserved Horizontal gaze was preserved. No nystagmus. Pupil was round and reactive to light. No abnormalities were detected in the rest of the anterior and posterior segment evaluation of both the eyes. MRI was done and concluded acute infarcts at the bilateral paramedian thalamus and midbrain region. The patient is neurosurgically managed and was started on antiplatelets and anticoagulants .