A Case of Bilateral Marcus-Gunn Syndrome.

Choi, Sung Wook; Yang, Jae Wook; Lee, Sul Gee

doi:2009.50.2.299

J Korean Ophthalmol Soc > Volume 50(2); 2009 > Article

Case Report

Journal of the Korean Ophthalmological Society 2009;50(2):299-302.
DOI: https://doi.org/10.3341/jkos.2009.50.2.299 Published online February 15, 2009.

A Case of Bilateral Marcus-Gunn Syndrome.

Sung Wook Choi, Jae Wook Yang, Sul Gee Lee

Department of Ophthalmology, Inje University College of Medicine, Pusan Paik Hospital, Pusan, Korea. judysg@hanmail.net

양측성 마쿠스 건 증후군 1예

최성욱ㆍ양재욱ㆍ이슬기

Department of Ophthalmology, Inje University College of Medicine, Pusan Paik Hospital, Pusan, Korea

Abstract

PURPOSE
To report a case of bilateral Marcus Gunn syndrome, which can be easily overlooked. CASE SUMMARY: A 6-year-old boy visited our clinic complaining of right ptosis. On ocular examination, the palpebral fissure width was 4 mm in the right lid and 7 mm in the left lid. Marginal reflex distance 1 (MRD 1) was -1 mm in the right lid and 2 mm in the left lid. Bilateral levator muscle function was good. When the patient moved the jaw to the right side, the left eyelid was retracted by 2 mm, and when the jaw was moved to the left side, the right upper eyelid retracted by 4 mm, which showed a moderate bilateral jaw-winking phenomenon. There was no change in bilateral palpebral fissure width when only opening the mouth without jaw movement. CONCLUSIONS: Asymmetrical bilateral ptosis can be easily misdiagnosed for unilateral ptosis, and concurrent Marcus Gunn phenomenon can exist. Therefore, a thorough examination is necessary when examining a ptosis patient.

Key Words: Bilateral marcus gunn syndrome;Jaw-winking phenomenon;Ptosis