Abstract

Purpose-To report a case of ptosis in a bilateral posterior communicating artery agenesis.
Method-Case report
Results-A 61-year-old female presented to OPD for acute onset right upper eyelid ptosis for 7 days.It was nonprogressive & painless without any double vision. History of two recent episodes of syncope was present.Ocular exam-VA FC 4m RE and FC 3m LE.
RE severe ptosis (MRD1:-4mm),intact corneal sensations BE & pupillary reaction present BE.
Extra ocular movement restricted in all gaze except abduction & depression in abduction in RE.Lens cataractous BE.Fundoscopy WNL BE.
Investigations: PPBS-256 mg/dl HBA1c-8.3%, MRI brain-ischemic demyelination in B/L basal ganglia. MRA brain-B/L posterior communicating artery agenesis.
Conclusion-T2DM causes ischemic nerve damage, & oculomotor palsy is the most frequent neurological complication. PComA agenesis also causes ischemic stroke.60% in BL cases & 40% in UL. Also PComA agenesis is very common,& occurs in 25%-35% of individuals.

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