Monocular accommodative fluctuations associated with temporomandibular joint syndrome

A young scientist reported severe headaches emanating from behind one eye with an associated intermittent monocular blur. The monocular near cross-cylinder test revealed an accommodative fluctuation of one eye alone with a range of approximately 3 D. Referral to a neuro-ophthalmologist failed to produce a diagnosis for the disorder. A subsequent routine visit to a dentist provided a diagnosis of Costen's temporomandibular joint (TMJ) syndrome, a condition that is commonly misdiagnosed as a variety of neurological and vascular disorders.