38-year-old complaints of intermittent diplopia in primary position constant in lateral gazes, worse when the patient is tired.
Past ocular history includes history of childhood strabismus, status post strabismus surgery in 2011 (No records available). Diplopia was present before he underwent surgery in 2011.
Past medical history positive for cognitive and balance problems since 2014 and 5 minutes’ transient visual loss. There is no history of ptosis, dysphonia, or muscle weakness.