A Case of Orbital Apex Syndrome Induced by Penetrating Orbital Injury with Long-Term Results.

Baek, Sung Uk; Lee, Min Joung

doi:2013.54.8.1275

J Korean Ophthalmol Soc > Volume 54(8); 2013 > Article

Case Report

Journal of the Korean Ophthalmological Society 2013;54(8):1275-1281.
DOI: https://doi.org/10.3341/jkos.2013.54.8.1275 Published online August 15, 2013.

A Case of Orbital Apex Syndrome Induced by Penetrating Orbital Injury with Long-Term Results.

Sung Uk Baek, Min Joung Lee

Department of Ophthalmology, Hallym University College of Medicine, Annyang, Korea. minjoung@hallym.or.kr

안와관통상으로 인해 발생한 안와첨증후군의 장기 경과 관찰 1예

백성욱⋅이민정

Department of Ophthalmology, Hallym University College of Medicine, Annyang, Korea

Abstract

PURPOSE
To report a case of orbital apex syndrome induced by penetrating orbital injury by a wire with the recovery process and clinical outcomes. CASE SUMMARY: A 40-year-old female visited our clinic after a penetrating orbital injury through the left inferomedial conjunctiva by a wire. The best corrected visual acuity of the left eye was 0.6, and ptosis and total ophthalmoplegia were observed. The patient showed a dilated pupil, swelling of the optic disc on fundus exam, and an inferior field defect on the automated perimetry. The computed tomography image revealed mild retrobulbar hemorrhage, but there was no orbital bony fracture. Enhancement of the optic nerve sheath was observed on the magnetic resonance image. The patient was admitted and received systemic antibiotics and steroid treatment. After 1 month, visual acuity, ptosis, and limitation in adduction were partly improved. After 3 months, depression and adduction were improved and the pupil size was normalized. However, further improvement was not observed after the one-year follow-up. CONCLUSIONS: The recovery from orbital apex syndrome was achieved until 3 months after injury. The final outcomes may depend on the mechanism and pathophysiology of the injury. Emergent diagnosis and proper management are essential to achieve optimal clinical results.

Key Words: Orbital apex syndrome;Penetrating orbital injury