Pseudoptosis due to acute dacryoadenitis: An unusual presentation of Epstein–Barr virus infection in a child

A BSTRACT Epstein–Barr virus (EBV), a common human herpesvirus, usually causes a self-limited illness in children, manifested by fever, pharyngitis, and lymphadenopathy. However, patients may have atypical presentations including rare ocular manifestations like uveitis, dacryoadenitis, ptosis, or pseudoptosis. In this report, we describe EBV presenting as pseudoptosis in a previously healthy 7-year-old boy. The child was initially worked up as having possible myasthenia gravis with neurologic and ophthalmologic consultations. Ultimately, he was diagnosed with viral dacryoadenitis due to acute EBV infection causing pseudoptosis. We present this case to highlight rare ocular manifestations in EBV which are important to recognize to prevent misdiagnosis and unnecessary investigations.