15/08/2026
45-year-old female presented with progressive inward deviation of both eyes over the last 15 years. Right eye refraction was not possible, but she was wearing myopic glasses (-22 D) left eye. Axial lengths were 37.5 mm right and 37.66 mm left. Fundus examination showed myopic changes with chorioretinal atrophy and peripapillary atrophy. Esotropia (ET) estimated to be greater than 120 PD was present with complete limitation of abduction and elevation in both eyes.
What is the most probable diagnosis?
A) Thyroid ophthalmopathy
B) Bilateral sixth cranial nerve palsy
C) Myasthenia gravis
D) Heavy eye syndrome