Simultaneous Bilateral Painful Ophthalmoplegia and Exudative Retinal Detachment in Rheumatoid Arthritis

SUWANNA SIN SA WAIWONG, M.D.*, CHAKREE HIRUNPAT, M.D.**, NANTAPORN TIYAPUN, M.D.*, KITTI LIMAPICHAT, M.D.*

Affiliation : ** Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Hat Y ai, Songkhla 90112, Thai- land.

AbstractA 47-year-old woman who suffered from chronic [heumatoid arthritis presented with bilaterai painful ophthalmoplegia with proptosis and exudativeretinal detachment. The painful ophthalmoplegia with proptosis might-have been caused by pachymeningitis involving the cavernous sinus bilaterally, or bilateral posterior scleritis spreading to the extraocular muscles and tendons. The exudative retinal detachment might have been a result of bilateral posterior scleritis which had spread to the choroid. These two unusual complications of rheumatoid arthritis occurred simultaneously in this case. Both complications responded to corticosteroid treatment.

Keywords : Painful Ophthalmoplegia, Retinal Detachment, Pachymeningitis, Posterior Scleritis, Rheumatoid Arthritis

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