Successful treatment of Traumatic orbital apex syndrome with low dose steroids - a case report

Tharini Senthamizh; Subashini Kaliaperumal

Volume : IX, Issue : VIII, August - 2020

Successful treatment of Traumatic orbital apex syndrome with low dose steroids - a case report

Tharini Senthamizh, Subashini Kaliaperumal

Abstract :

Traumatic Orbital Apex Syndrome is a rare complication of trauma presenting with visual loss, ophthalmoplegia, and anesthesia of cornea, forehead and maxillary regions. It requires immediate action as it poses great threat to permanent visual loss. The incidence of Traumatic orbital apex syndrome is very less compared to Superior Orbital fissure syndrome and traumatic optic neuropathy alone and only few cases have been reported till now. Management depends on the cause, those with displaced fracture fragments are treated by surgical decompression whereas those with edema or hematoma causing compression can be treated with steroids or surgical evacuation of hematoma. Previous reports have proved the usefulness of mega dose steroids in such cases. We report a case of Traumatic Orbital Apex Syndrome who presented with painful proptosis, visual loss, ophthalmoplegia and loss of sensation in periorbital region. Imaging confirmed hematoma causing compression of neurovascular structures and hence a trial of low dose corticosteroids was started. Our patient showed dramatic improvement in signs and symptoms with complete recovery in three weeks. Low dose steroids can be considered as an alternative to mega dose steroids to treat patients with indirect traumatic Orbital Apex Syndrome, thereby reducing the necessity of surgical evacuation in such cases.