IBD flare up sees man unable to open right eye

A patient in his 60s with inflammatory bowel disease developed ptosis and diplopia

Pixabay/Darko Djurin

BMJ Case Reports authors have described a case of oculomotor nerve palsy as a manifestation of Crohn’s disease.

Greek clinicians described how a man in his 60s developed pain in his right eye followed by complete ptosis three days later.

When the eyelid was manually lifted, the patient experienced diplopia in all gaze directions except to the right.

The patient had previously experienced iridocyclitis, treated with steroid eye drops, since being diagnosed with Crohn’s disease in 2000. However, the patient described this episode as different.

“I woke up in the morning to find that I couldn’t open my right eye. This was new for me and certainly did not remind me of iridocyclitis,” he shared.

After normal brain imaging results, the patient was prescribed corticosteroids. The treatment provided immediate relief to the pain in his eye and eyelid elevation gradually improved.

“He has returned to his normal daily activities and feels confident that all symptoms will gradually subside,” the authors shared.

They highlighted that neurological complications of inflammatory bowel disease are rarely reported.

“Early recognition and treatment of neurological complications are crucial for preventing major morbidity,” they emphasised.