PMC5234296_01
Photographs demonstrating ophthalmoplegia secondary to the right third nerve palsy with involvement of the pupil. The center panel demonstrates the extent of ptosis at rest and characteristic "down and out" position of the eye. Remaining images demonstrate eye position during voluntary gaze in each direction relative to the center panel
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F1
However, 2 days later, the patient progressively developed a frontal headache, right eye ptosis, and inferolateral displacement of gaze with mild mydriasis of the the right pupil (4 mm OD vs. 2 mm OS), consistent with a right third nerve palsy with partial pupillary involvement [Figure 1].
Post-procedure average recorded blood glucose (mg/dL) over 1 month after epidural steroid injection (ESI). Each point represents the average blood glucose obtained from the patient's personal glucometer calculated in 3-day bins. Initial value (day 0) reflects the blood glucose level recorded at the treatment center immediately before ESI
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F2
For 3 days following the ESI, the patient's OneTouch glucometer (LifeScan Inc., Wayne, PA) revealed transient elevation in his blood glucose levels [Figure 2].
Photographs demonstrating resolution of the third nerve palsy 4 months after epidural spinal injection. The center panel demonstrates the position of the eye at rest. Remaining images demonstrate eye position during voluntary gaze in each direction relative to the center panel
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F3
Within 4 months, the ophthalmoplegia and pupillary dysfunction resolved, and the patient was left with only a mild residual ptosis [Figure 3].