Uncorrectable Oblique Astigmatism and Impaired Binocular Vision in Case of Orbital Cherubism

摘要

A 22-year-old Japanese woman presented with diplopia of 12 years duration. She had a history of cherubism and had had repeated osteoplasties of the mandible. A left hypertropia with "A" pattern exotropia, bilateral superior oblique overaction, inferior oblique underaction, and incyclotorsion were present. The bilateral field of fusion determined by Goldmann perimetry showed diplopia in all fields except 10-20 degrees of the central field. Corneal topographic measurements showed characteristic oblique astigmatism due to the incyclotorsion. Titmus stereoscopic test showed depressed stereoacuity. The astigmatism was too large and axes too variable during eye movements to be corrected with spectacles, and the retraction of the lower lid prevented a proper fitting of contact lens. Thus, we conclude that orbital cherubism has many ophthalmological difficulties that are not easily correctable or treatable.