Dr.Mrunmayi Jeste, M21554
IDA, though a rare cause of ischemic stroke, has been found to be an important risk factor in otherwise healthy children. An 8-year-old boy presented with sudden onset binocular vertical diplopia since one day. On examination, both eyes showed grade -4 up gaze restriction and grade -2 down gaze restriction with rotatory nystagmus. Visual acuity was 6/6 in both eyes and rest of the anterior and posterior segments were within normal limits. MRI was suggestive of localized acute infarction in left paramedian upper midbrain at the level of red nucleus. Blood workup showed hemoglobin of 9.9 g/dL, Serum Ferritin 6.78 ng/ml, iron 30 µg/dl with peripheral blood smear showing hypochromic microcytic anemia being suggestive of IDA. After neurologist consultation, patient was started on treatment for IDA. Significant improvement was observed on two weeks follow-up. This case highlights the ophthalmologist’s role in recognizing an easily manageable cause of ischemic stroke in children
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