An 8-year-old boy presented to the pediatric ophthalmology clinic for evaluation of red eyes for the past year with progressive worsening in the past 6 months. The symptoms were not associated with pain, photophobia, or discharge. The child had been diagnosed with congenital ataxia as a toddler. However, the parents also reported worsening of the child's wobbling gait during the 6 months before presentation to the eye clinic.
The child had been born at term via cesarean section. His medical history was significant for asthma and a speech delay. Family history included a "stable resting tremor" in his mother and an aunt. As part of his evaluation for ataxia as a toddler, MRI and chromosomal microarray analysis had been performed and were both negative at that time.
The external ocular examination was normal. Visual acuity was 20/50 in the right eye and 20/70 in the left eye. Pupils were briskly reactive to light, with no relative afferent pupillary defect. Intraocular pressures, extraocular movements, and confrontation visual fields were within normal limits.
On slit-lamp examination, dilated conjunctival vessels were visualized bilaterally (Figures 1-4). Corneas were clear, with a deep and quiet anterior chamber in each eye. The lids, lashes, iris, lens, vitreous, and direct funduscopic examination were normal bilaterally. Refractive error was -1.00 sphere in both eyes.
Because of the child's worsening ataxia, a neurologic examination was also performed. The examination was significant for slow, scanning speech. Finger-to-nose examination revealed dysmetria. The patient was noted to have an unsteady, slightly wide-based gait.
Medscape Ophthalmology © 2016
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Cite this: The Boy With Red Eyes and a Wobbling Gait - Medscape - Aug 18, 2016.