Oculofacial paralysis with simultaneous bilateral abduction in Bell's phenomenon and bilateral disc colobomas

Abstract

A case of congenital bilateral third, fourth and seventh nerve palsy with simultaneous bilateral abduction in Bell's phenomenon and bilateral optic disc colobomas is reported. The patient presented with bifacial diplegia, right sided ptosis, complete lack of vertical and rotatory movements, large exotropia with defective adduction, poor visual acuity and retinal detachment of the right eye. MRI findings confirmed absence of the third nerve. It is suggested that the congenital ocular fibrosis syndrome and Mobius' syndrome are closely associated neural abnormalities.

Key Words:

• Mobius' syndrome
• Duane's retraction syndrome
• congenital ocular fibrosis syndrome
• synergistic divergence
• Bell's phenomenon