Re(4): Ptosis and addiction deficit

If it isnít congenital then itís acquired bilateral 3rd nerve palsy and needs scanned.

(One aspect that suggests it is longstanding, is the absence of diplopia despite their being manifest strabismus)

Iíd suggest review the history again with particular attention to when the abnormal eye movement were first noted.

If truely it is a 1 year history then I would ask for urgent neuro imaging.

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