DR. ROHINI HARI

Dr.DR. RAVI VAISHNAVI, Dr. STEPHEN SUDHAKAR

Abstract

A 50year old man presented with complaints of sudden diminution of vision, diplopia,severe pain in right eye for 3days.On examination visual acuity was perception of light in right eye,left eye within normal limits.He had proptosis,grade1 RAPD ,restricted extraocular movements for dextroversion, dextroelevation and depression and hypertropia in right eye which increases with head tilt to same side. Orbital apex syndrome was suspected as the Second, fourth and sixth cranial palsy in right side was observed. Since Both eyes fundus examination and MRI brain plain with orbital screening was normal ,Retrobulbar neuritis was suspected. patient was advised to do MRI orbit contrast /MRA/Cavernous sinus screening which showed mild increase in enhancement in the right cavernous sinus suggestive of Tolosa Hunt Syndrome.Patient was started on intravenous steroid for five days followed by oral steroids .Patient was symptomatically better.