Isolated sixth cranial nerve palsy in a case of severe pre eclampsia presenting as postpartum diplopia

Visual symptoms in pregnancy are ominous. The spectrum of ocular symptoms seen in pre eclampsia includes blurring of vision, scotoma, hemianopia and even total cortical blindness. Diplopia, though rare has also been reported in cases of pre eclampsia and occurs due to pathological changes affecting the 6th cranial nerve. Ocular symptoms of pre eclampsia usually regress after delivery but occasionally may present in the postpartum period. We present a case of a 34-year-old lady with severe pre eclampsia at 31 weeks of gestation with diplopia presenting seven days post caesarean section. No identifiable pathology was found and the condition recovered spontaneously once blood pressure control was achieved.