Filamentary keratopathy caused by corneal occlusion by large-angle paralytic strabismus.

Objective: To report a case of filamentary keratopathy in a patient with large-angle paralytic strabismus.

Methods: A 31-year-old man who had a traffic accident was diagnosed to have third cranial nerve palsy and a large-angle exotropia in his right eye. The patient complained of foreign body sensation in his right eye 2 months after the accident.

Results: Slit-lamp examination showed multiple filaments on the right cornea. Debridement of the filaments and artificial tears relieved the symptoms and were used until the paralysis resolved.

Conclusions: Large-angle paralytic strabismus with ptosis and poor elevation and depression of the eye may occlude the cornea and lead to filamentary keratopathy.