| Summary: | Background: Wernicke's encephalopathy, a condition characterized by a triad of mental confusion, ophthalmoplegia, and gait ataxia, can be reversed if treatment is initiated promptly. This case examines optometry's role in comanagement when patients present with oculomotor manifestations of this condition. Case Report: A 53-year-old Caucasian male diagnosed with Wernicke's encephalopathy was referred to the VA optometry clinic with symptoms of oscillopsia and diplopia. Examination revealed that his symptoms were caused by upbeat nystagmus and an acquired large-angle alternating esotropia. Over the course of several months, in conjunction with systemic treatment, the patient's ocular symptoms completely resolved. However, many of his systemic manifestations persisted. Conclusions: This paper reviews literature discussing sudden-onset esotropia and nystagmus in cerebellar disease and defines optometry's role in treatment.
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