A case of orbital apex syndrome caused by an injury

Abstract

Orbital apex syndrome is characterized by mydriasis, blepharoptosis, exophthalmos, ocular motility disorder, eyelid sensory disorder and visual disorder due to damage of the oculomotor nerve, the trochlear nerve, the abducens nerve, the trigeminal nerve and the optic nerve at the orbital apex. A tumor, cyst, inflammation and injury can cause orbital apex syndrome. This report describes a case of 55-year-old male whose maxillary paries anterior was destroyed by an exploding bolt that impacted the maxillary bone chip to the orbital apex caused lose of left vision, left mydriasis, absence of the left light reflex, ocular motility disorder in all directions and left facial imperception. Damage of the left optic nerve was recognized by CT and MRI. The bone chip was surgically removed under general anesthesia. The ocular motility improved after the operation, but the visual handicap thereafter remained.