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ABSTRACT
Binocular triplopia is a rare symptom and usually has a corneal or lenticular origin. Uniocular diplopia arising from ectopia lentis is quite common in Marfan syndrome. A visual phenomenon related to binocular triplopia due to strabismus was first reported in 1943 by Burian. Both monocular diplopia and binocular triplopia have been reported in concomitant strabismus. Strabismus is also common in Marfan syndrome but congenital superior oblique paresis has never been reported before. We report herein a rare case of binocular triplopia in a patient with Marfan syndrome arising from decompensation of his coexistent congenital superior oblique paresis triggered by his uniocular diplopia. This is the first report of congenital superior oblique paresis in a patient with Marfan syndrome. Though it is unlikely to have any etiological implications and is likely to be a mere coincidental simultaneous occurrence, it had a confounding effect on the clinical interpretation of the signs and symptoms posing an interesting diagnostic and management dilemma. Our case report emphasizes the necessity for careful evaluation of any patient with symptoms of triplopia. We further review and summarize all the causes of binocular triplopia published in English literature and propose an approach to its evaluation and management.
Acknowledgments
We sincerely acknowledge the contributions of Ms. Rosanne B.Keep; MS; CGC, New Jersey; USA, in editing our manuscript for the use of English language.
Declaration of Interest Statement
We do not have any conflict of interest. We do not have any financial conflict of interest. We have not received any funding or sponsorship for the study.
Financial Conflict of Interest
We do not have any financial conflict of interest.