Dr. Akshay Kothari, K17272, Dr. Anirban Chakrabarti, Sreya Biswas
Case Report: A 27 year old male came with the chief complaint of sudden painful loss of vision in left eye (LE) following blunt trauma to left side of head due to fall from vehicle one day back. Positive findings in LE were ptosis, subconjunctival haemorrhage, axial proptosis and restricted ocular movements in all quadrants. Visual acuity in LE was no Perception of Light (No PL). Direct and Consensual light reflex in LE were absent. Consensual light reflex in right eye was also absent. CT Orbit showed normal bony outline. MRI Orbit was suggestive of inflammatory changes in left orbital apex and superior orbital fissure. Methyl prednisolone 1gm/day intravenous infusion daily for 3 days followed by oral prednisolone acetate in tapering dose (starting with 1mg/kg body wt) was given. Post treatment VEP showed no wave formation in LE and the vision was no PL at 1 month follow up.
Conclusion: Traumatic Orbital Apex Syndrome carries a bad prognosis if the visual acuity at presentation is poor