ORBITAL APEX SYNDROME

Abstract

The orbital apex syndrome is a relatively uncommon entity, characterized by retrobulbar pain, supraorbital nerve hypoesthesia, palpebral ptosis, loss of vision, ophthalmoplegia and fixed mydriasis caused by involvement of the structures within the orbital apex, namely, second (optic), third (oculomotor), fourth (trochlear), fifth (Opthalmic divison of trigeminal) and sixth (abducens) cranial nerves. Presenting a case of 62 year diabetic male with complaints of loss of vision, ptosis. Management of orbital apex syndrome mainly depends upon localization of the lesion, identification of the etiology followed by full course of antifungal therapy. Clinical diagnosis was supplemented with imaging modalities, like contrast enhanced computed tomography (CECT) of the orbits and paranasal sinuses, as well as MRI PNS with orbits, along with lab investigations. In this article, we attempt to explain in detail the symptomatology, clinical and radiological findings and management of the case.