J Med Assoc Thai 1999; 82 (11):1170

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Simultaneous Bilateral Painful Ophthalmoplegia and Exudative Retinal Detachment in Rheumatoid Arthritis
Sinsawaiwong S Mail, Tiyapun N , Hirunpat C , Limapichat K

A 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.
Key word : Painful Ophthalmoplegia, Retinal Detachment, Pachymeningitis, Posterior Scleritis, Rheumatoid Arthritis

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