Ocular Flutter as The First Sign of a Breast Carcinoma

Article Abstract
Introduction: Ocular flutter is a rare ophthalmic finding and can be the presenting sign of potentially serious disease. The most common etiology is a paraneoplastic disorder and therefore, a workup for a malignancy should always be initiated.

Case Report: We present a case of a 48-year-old female who presented with a two-month history of progressive anorexia, wasting, vomiting and vertigo and recently associated complaints of diplopia and blurred vision. Ophthalmic examination revealed horizontal saccadic intrusions, consistent with ocular flutter. Further extensive workup revealed an adenocarcinoma of the right breast. Immunologic testing showed positive anti-Ri antibodies which are reported to be associated with breast carcinomas and a paraneoplastic syndrome. The patient underwent local excision and adjuvant chemotherapy, radiotherapy and hormonal therapy were administered. The clinical picture deteriorated rapidly to an overt opsoclonus and a gait disorder. Six months after the initial presentation, she became symptom free.

Conclusion: Ocular flutter is an alarming finding and should always alert the clinician to screen for a potential underlying malignancy.

Article Citation:

Maes C, Janssens H, Goovaerts L, Dieltiens M, Schrooten M, Cassiman C. Ocular flutter as the first sign of a breast carcinoma. Video Journal of Clin Ophthalmol 2017;1:1–4.

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