Blurred vision does not necessarily mean presbyopia

Mr. Ji from Hunan is 46 years old this year. He has always felt a little dizzy and had double vision in the past year. It is normal for people of a certain age to feel a little dizzy and blurred vision, so Mr. Ji did not take it seriously. But gradually, the dizziness became more and more severe, and he could not stand it, so he bought a pair of glasses. But not long after wearing the glasses, he felt that the glasses were not suitable, and his vision became more and more severe.

In desperation, Mr. Ji went to an ophthalmologist for an eye test. After checking at the ophthalmologist, he found that it was not just presbyopia. In addition to the refractive error of presbyopia, which is normal for far vision but blurry for near vision, there is also paralysis of the rectus muscles due to damage to the abducens nerve, which leads to diplopia. This diplopia caused by strabismus cannot be corrected by reading glasses alone. As for why Mr. Ji's abducens nerve was damaged, the ophthalmologist recommended that he go to the neurology department for a check-up.

The neurosurgeon suggested a routine head CT scan first. The CT scan showed a suspicious mass in the nasopharynx. The doctor suspected that the mass compressed the skull base, causing damage to the abducens nerve. The neurosurgeon suggested that Mr. Ji go to the ENT department for further examination. When he arrived at the ENT department, the doctor looked at the CT scan, asked a few simple questions, and understood. The doctor explained that in addition to double vision, Mr. Ji also had symptoms of dizziness and tinnitus. Although these symptoms are not specific, they suggest that they may be early symptoms of nasopharyngeal cancer.

After the fiber nasal endoscopy, the truth came to light. Mr. Ji's diplopia was caused by nasopharyngeal cancer. The first symptoms of nasopharyngeal cancer in the early stage are usually headache, nasal congestion, tinnitus, and bloody nose. In this case, the patient did not have the most obvious symptom of bloody nose. Instead, he had a rare symptom called diplopia along with his headache. This made the diagnosis complicated and tortuous. Fortunately, Mr. Ji's cancer developed slowly. After receiving radiotherapy, his physical condition stabilized and he was discharged from the hospital. Follow-up six months later showed no recurrence.