<p>Orbital Apex Syndrome: A Review</p>

Abstract

Orbital apex syndrome is characterized by vision loss from optic neuropathy and ophthalmoplegia due to the involvement of ocular motor nerves in the anatomical region of the orbital apex. Patients could present with signs and symptoms deriving from the involvement of structures within the orbital apex, the superior orbital fissure or the cavernous sinus. The primary focus of the ophthalmologist should be to locate the lesion and then identify its etiology. Clinical evaluation holds key to diagnosis which is aided then by certain serological and lab investigations and neuro-imaging modalities including brain and orbital MRI (Magnetic Resonance Imaging) with contrast, CT (Computed Tomography) scans. In rare instances, a biopsy may be needed to aid in diagnosis. Treatment depends on what the nature of the lesion is with inflammatory conditions usually responding to steroids and infections to anti-microbial agents. Through this review, the authors attempt to decode the approach to localizing the lesion, the etiopathology and the management of cases of orbital apex syndrome

Orbitocranial Penetrating Injury With Multiple Vessel Invasion in an Infant: A Case Report and Literature Review

“…In our infant patient, it was difficult to assess trigeminal nerve-related symptoms such as anesthesia of the forehead. However, the patient exhibited oculomotor palsy and deficiency of the trochlear and abductor nerves, which is a manifestation of traumatic superior orbital fissure syndrome (Figures 4B,C) (13,14). In comparison, FBs near the optic nerve or the ICA are more likely to enter the suprasellar cistern directly (8).…”

Granulomatosis with Polyangiitis Presenting with Bilateral Orbital Apex Syndrome

“…OAS is characterized by optic neuropathy and total ophthalmoplegia caused by the damage of II, III, IV, V1, and VI cranial nerves due to the lesion of the orbital apex. The differential diseases broadly include infection, noninfectious inflammation such as sarcoidosis, idiopathic intraorbital inflammation, hypertrophic pachymeningitis, rheumatic polyarthritis, tumor invasion, vasculitis, and trauma [ 10 ]. Here, we report a case of GPA presenting with bilateral OAS caused by the spread of inflammation from extensive ethmoid sinusitis, in which visual function was completely recovered using a combination of early optic nerve decompression and treatment with oral prednisolone and cyclophosphamide.…”

A systematic review of orbital apex syndrome of odontogenic origin: Proposed algorithm for treatment

“…Due to the anatomical proximity of the orbital apex, cavernous sinus syndrome and superior orbital fissure syndrome share similarities with OAS. 1…”