We report a rare instance of favorable outcome in orbital apex syndrome secondary to herpes zoster ophthalmicus (HZO) in a human immunodeficiency virus (HIV)-positive patient. The patient complained of pain and decrease in vision in one eye (20/640) for 2 weeks accompanied with swelling, inability to open eye, and rashes around the periocular area and forehead. The presence of complete ophthalmoplegia, ptosis, relative afferent pupillary defect, and anterior uveitis with decreased corneal sensation prompted a diagnosis of HZO with orbital apex syndrome. The enzyme-linked immunosorbent assay test and a low CD4 count confirmed HIV. Highly active antiretroviral therapy (HAART), systemic acyclovir, and systemic steroids were started. Visual acuity and uveitis improved within 10 days. By the end of the fourth week, ocular motility also recovered and the final visual acuity was 20/25. We highlight the role of HAART, used in conjunction with systemic steroid and acyclovir therapy, in improving the outcome.
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http://dx.doi.org/10.4103/0301-4738.71708 | DOI Listing |
Osteoblastoma is an uncommon benign bone tumor rarely involving the craniofacial skeleton. Manifestations in the fronto-orbital region are exceptionally rare. A 19-year-old man presented with persistent headache, nausea, vomiting, right eye pain, and longstanding right exophthalmos.
View Article and Find Full Text PDFCureus
December 2024
Neuro Ophthalmology, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Puducherry, IND.
A five-year-old female came with a history of frequent rubbing of the right eye and noticed prolonged elevation of her head since birth, informed by her mother. On ocular examination, the best corrected visual acuity shown in the right eye was 1/60, and the left eye was 6/6, with proptosis in both eyes. Fundus examination showed both eyes having pale discs.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Department of Ophthalmology, Rochdale Infirmary, Rochdale, UK.
Sweet syndrome (SS), or acute febrile neutrophilic dermatosis, is a dermatologic, auto-inflammatory disorder of unclear origin, often accompanied by systemic inflammation affecting various tissues, including the eyes. Common ocular manifestations include conjunctivitis but can extend to other ocular tissues. Orbital apex syndrome (OAS) involves damage to several cranial nerves transversing the orbital apex, leading to ophthalmoplegia and vision loss.
View Article and Find Full Text PDFHeadache
January 2025
Bangalore Medical College and Research Institute, Bangalore, India.
Objective: This systematic review aims to consolidate and analyze the existing evidence on Tolosa-Hunt syndrome (THS) in the pediatric population, focusing on clinical features, diagnostic challenges, treatment outcomes, and prognosis.
Background: Tolosa-Hunt syndrome is a rare headache disorder caused by idiopathic inflammation of the cavernous sinus, orbital apex, or orbit, resulting in neuro-ophthalmological manifestations. It is uniquely characterized by cranial nerve palsies and often responds well to steroids.
Ophthalmic Plast Reconstr Surg
December 2024
South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide.
The authors present a case of an orbital apex venous malformation that presented with an intermittent oculomotor nerve palsy over a 15-year period. Radiologically, the lesion presented as a well-circumscribed orbital mass with T2 hyperintensity and enhancement that could only be demonstrated on 2-hour delayed phase imaging. The venous malformation was initially steroid-responsive but eventually became refractory to medical treatment alone.
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