Indian Journal of Ophthalmology

INTERESTING CASES
Year
: 1987  |  Volume : 35  |  Issue : 1  |  Page : 39--40

Bilateral jaw-winking (marcus gunn's phenomenon) (a case report)


Santhosh Kumar Banerjee1, Pradip Chatterjee2,  
1 Reader, R.G.Kar Medical College, India
2 Lecturer, N.B. Medical College, India

Correspondence Address:
Santhosh Kumar Banerjee
Reader, R.G.Kar Medical College
India

Abstract

A bilateral rare case of Marcus Gunn«SQ»s phenomenon has been reported.



How to cite this article:
Banerjee SK, Chatterjee P. Bilateral jaw-winking (marcus gunn's phenomenon) (a case report).Indian J Ophthalmol 1987;35:39-40


How to cite this URL:
Banerjee SK, Chatterjee P. Bilateral jaw-winking (marcus gunn's phenomenon) (a case report). Indian J Ophthalmol [serial online] 1987 [cited 2021 Jun 16 ];35:39-40
Available from: https://www.ijo.in/text.asp?1987/35/1/39/26319


Full Text

Marcus Gunn's phenomenon is a rare condition (V.Nevin & Kiloh, 1972). This peculiar and dramatic paradoxical movement, first noticed by Marcus Gunn (1893), is the most common congenital synkinetic movement. It is typically congenital, unilateral and associated with ptosis, but rarely with any other muscular anomaly of the eyes. It is characterised by ptosis, and lid retraction occurs when the mouth is opened. Speath (1947) estimated its incidence as 2% of all cases of congential ptosis. Rarely this phenomenon is bilateral (Schultz & Burian, 1960) in which case the lids can be raised only when the mouth is opened. Recently we came across a case of bilateral Marcus Gunn's phenomenon which is being reported for its rarity.

 CASE REPORT



A 12 year old boy was brought to eye O.P.D. of Burdowan Medical College & Hospital with complaints of dropping of the upper lids (both eyes) when looking straight ahead and tendency to raise the chin to overcome the adverse effect of ptosis On opening the mouth both eye-lids were opened. He has no other abnormalities.

 DISCUSSION



Bilateral Marcus Gunn's phenomenon is a very rare condition (Duke Elder 1964) Schultz & Burian (1960) reported a case of bilateral Marcus Gunn's phenomenon wherein patients exhibited bilateral but asymmetric limitation of elevation of each eye; normal lid position in straight ahead gaze, left sided 1-evator was inhibited during gaze to the right or upward; bilateral levator excitation with opening of the mouth was present and seesaw lid movement with forceful movements of jaw from side to side.

Systemic anomalies occurring in association with this phenomenon are rare. Schultz & Burian (1960) reported a case of bilateral Marcus Gunn's phenomenon with spina bifida occulta, ectrodactyly, bilateral pes cavus, reduplication of the teeth & undescended testicles. Butt in our case no such anomalies were seen. A hereditary tendency in the Marcus Gunn's phenomenon has been noted. It behaves as an irregular autosomal dominant but may appear in one sibling only. No such hereditary tendency was noted in this case. His parents, brothers and sisters were normal.

 ACKNOWLEDGEMENT



We are grateful to the Superintendent, Burdowan Medical College & Hospital, Burdowan for permitting us to publish this paper.[5]

References

1Duke Elder,S : System of Ophthalmology, Vol.III, Part 2 Page 900 - 902 Henry Kimpton, London (1964)
2Nevin,S & Kiloh, L.G.: Modern Ophthalmology, 2nd Edition. Edited by Sosby, A.Vol.II Page 431 (1972).
3Schultz & Burian: Arch Ophthal (Chicago): 64:946 - 950 (1960)
4Speath : Amer. J.Ophthal., 30,143 (1947)
5Walsh & Hoyt Clinical Neuro Ophthalmology, Vol.I, Page 316 - 317 (1969).