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Orbital Apex Syndrome: A Review

Authors Badakere A, Patil-Chhablani P

Received 16 April 2019

Accepted for publication 8 November 2019

Published 12 December 2019 Volume 2019:11 Pages 63—72

DOI https://doi.org/10.2147/EB.S180190

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Professor Margaret Wong-Riley


Akshay Badakere,1 Preeti Patil-Chhablani2

1Jasti V Ramanamma Children’s Eye Care Centre, Pediatric Ophthalmology And Neuro-ophthalmology Services, L V Prasad Eye Institute, Hyderabad 500034, India; 2Department of Ophthalmology, Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center, UPMC Eye Center, Pittsburgh, PA 15224, USA

Correspondence: Preeti Patil-Chhablani
Department of Ophthalmology, Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center, UPMC Eye Center, Pittsburgh, PA 15224, USA
Email drpreetipatil@gmail.com

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

Keywords: orbital apex syndrome, Tolosa Hunt syndrome, orbital mucormycosis, orbital imaging


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