Functional paralysis of horizontal gaze
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Updated: Aug 18, 2026

Driving Simulation in the Clinic: Testing Visual Exploratory Behavior in Daily Life Activities in Patients with Visual Field Defects
Published on: September 18, 2012
Abstract:
A 52-year-old steelworker displayed a consistent defect in leftward voluntary gaze across the midline. Both fast (saccadic) and slow (pursuit) eye movements were affected. Neuro-ophthalmologic evaluation revealed no additional neurologic or ophthalmologic deficit. Pupilary miosis occurred during leftward gaze attempt, indicating that the gaze palsy was due to spasm of the near reflex. Special maneuvers during clinical eye movement testing disclosed full ability to make normal horizontal fast and slow eye movements despite the apparent defect in "voluntary" leftward gaze.
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