Masquerade Case #4

This case was presented by Dr. Steven Archer at Pediatric Subspecialty Day 2016.

An 83-year-old woman is referred by her ophthalmologist for increasing vertical diplopia worse at near. She is bilaterally pseudophakic and has a history of renal cancer with a metastasis to the temporal lobe that was resected 5 years ago. The final diagnosis is convergence insufficiency and a small vertical deviation, but prism correction does not eliminate the diplopia.