Dr.Neha Singh, S17803, Dr. Jolly Rohatgi, Dr. (Mrs) Upreet Dhaliwal, Dr. Shubhank Khare
A young woman presented with acute onset diminuition of visionLE,painful ocular movements, and binocular diplopia since 10 days. Examination revealed VA of 5/60, mild proptosis(3mm),limitation on down & upgaze and RAPD with no signs of inflammation. Fundus revealed multiple bilateral disc drusen. ENT-NAD. Suspecting orbital cysticercosis /leaking demoid / orbital cellulitis MRI was done which revealed abscess of posterior aspect of SR muscle. A diagnosis of pyomyositis of superior rectus causing retrobulbar neuritis was made. IV antibiotics were administered. VA, diplopia improved with mild residual restriction of down gaze at 4 weeks and grade 1 RAPD.Repeat radioimaging showed only bulky muscle no abscess. Pyomyositis, a suppurative infection of striated muscle, rarely involves extraocular muscles. Only 8 cases have been reported till now. This case demonstrates a rare occurrence of superior rectus abscess causing retrobulbar neuritis which resolved with intravenous antibiotics alone.