Dr.Kiran Borah

Dr.Moushumi Majumder

Abstract

A 45-year-old female presented to OPD with Complete drooping of the right upper lid for one day. A detailed history was taken, and a thorough examination was done, where, along with drooping, the eyeball was depressed and abducted, the pupil was found to be mid-dilated and non-reactive to light, and EOM movement was restricted in elevation, depression, and adduction. Fundus examination of the right eye shows a flame-shaped hemorrhage in the supero-temporal quadrant of the retina. A series of investigations were done, and the case was finally diagnosed as a case of pupil involving complete 3rd nerve palsy with supero-temporal BRVO involving the right eye due to ischemic infarction in the ipsilateral midbrain. She was treated with Tab. Ecosprin, Tab. Atorvastatin, and Tab. Telmisartan; after the treatment, the pupil was sluggishly reactive and visual acuity was improved. The patient is still on medications and has regular follow-up.