LAUSR

An 11-year-old female with a history of juvenile idiopathic arthritis (JIA) presented with intermittent left eye pain and binocular vertical diplopia for 1 month, especially when the left eye was in adduction. She was not on any medications as she had been symptom free from JIA for a few years. On examination, visual acuity was 20/20 for each eye. Ocular motility was full, and she was orthophoric in all cardinal positions of gaze with no evidence of uveitis or conjunctival injection. Magnetic resonance imaging showed subtle increased T2 prolongation and enhancement within the left superior oblique (SO) insertion distal to the trochlear sling with enhancement around the trochlea, consistent with trochleitis (Figure 1). Ibuprofen 200 mg 3 times a day for 2 weeks was prescribed. Two weeks later, the double vision and eye pain were resolved with completely normal ocular evaluation. Trochleitis is an unusual form of inflammation localized in SO tendon and trochlear complex that has been associated with JIA with only a few case reports in the literature, all of them