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Gaze-Provoked Exotropia in a Young Woman

Educational Objective
Based on this clinical scenario and the accompanying image, understand how to arrive at a correct diagnosis.
1 Credit CME

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Article Information

Corresponding Author: M. Tariq Bhatti, MD, Department of Ophthalmology, Mayo Clinic, 200 First St SE, Rochester, MN 55905 (bhatti.muhammad@mayo.edu).

Published Online: May 2, 2019. doi:10.1001/jamaophthalmol.2019.1091

Conflict of Interest Disclosures: None reported.

Additional Contributions: We thank the patient for granting permission to publish this information.

References
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Soares-Dos-Reis  R, Martins  AI, Brás  A, Matos  A, Bento  C, Lemos  J.  Ocular neuromyotonia.  Pract Neurol. 2018;18(5):389-390. doi:10.1136/practneurol-2017-001866PubMedGoogle ScholarCrossref
3.
Much  JW, Weber  ED, Newman  SA.  Ocular neuromyotonia after gamma knife stereotactic radiation therapy.  J Neuroophthalmol. 2009;29(2):136-139. doi:10.1097/WNO.0b013e3181a57d19PubMedGoogle ScholarCrossref
4.
Sychev  YV, McInnis  CP, Francis  CE.  Abducens ocular neuromyotonia as a delayed complication of oropharyngeal carcinoma treated with radiation.  Head Neck. 2016;38(S1)(suppl 1):E2428-E2431. doi:10.1002/hed.24370PubMedGoogle ScholarCrossref
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Sze  WC, McQuillan  J, Plowman  PN,  et al.  Stereotactic radiosurgery XX: ocular neuromyotonia in association with gamma knife radiosurgery.  Endocrinol Diabetes Metab Case Rep. 2015;2015:140106.PubMedGoogle Scholar
6.
Giardina  AS, Slagle  WS, Greene  AM, Musick  AN, Eckermann  DR.  Novel case of ocular neuromyotonia associated with thyroid-related orbitopathy and literature review.  Optom Vis Sci. 2012;89(12):e124-e134. doi:10.1097/OPX.0b013e31827731bfPubMedGoogle ScholarCrossref
7.
Stockman  AC, Dieltiëns  M, Janssens  H,  et al.  Ocular neuromyotonia: case reports and literature review.  Strabismus. 2018;26(3):133-141. doi:10.1080/09273972.2018.1467469PubMedGoogle ScholarCrossref
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