A 40-year-old man complained of diplopia 4 days after trabeculectomy of the right eye 4 months before visiting our clinic. His corrected vision was 0.5 with − 5.50-diopter correction in the right eye and 1.0 with − 3.50-diopter correction in the left eye. Fundus examination revealed enlarged disc cupping in the right eye and a normal left eye. His VF examination showed an extremely constricted VF in the right eye, with only 7.5° × 5° remaining in the central island []. Prism-cover testing revealed 20 PD XT at the primary position. Ocular motility testing demonstrated no ophthalmoplegia. To eliminate the diplopia, we performed a right LRM recession of 7.0 mm. One month postoperatively, prism-cover testing revealed 3 PD right hypotropia. The patient described alleviation in diplopia, although it did occur sometimes. He also reported improved stereoacuity.
A 29-year-old man presented with diplopia after a traumatic skull base and orbital bone fracture 4 years prior. He was an architect and the diplopia considerably hindered his work. Ocular examination revealed the BCVA to be 1.0 in both eyes. Fundus examination revealed bilateral optic atrophy, and VF examination showed bitemporal hemianopia []. The prism-cover testing revealed 18 PD XT and 6 PD RH at the primary position. Ocular-motility testing demonstrated normal eye movement bilaterally. The Bagolini striated glasses test demonstrated right-eye suppression. To eliminate the diplopia, we performed LRM recession of 9 mm and SRM recession of 2 mm in the right eye. One month after surgery, prism-cover testing revealed 10 PD XT and 5 PD RH. Three months later, synoptophore testing demonstrated an unstable subjective angle from 1 to 3 PD XT and from 3 to 6 PD RH. The patient still experienced diplopia and could not tolerate prism glasses.