J Korean Ophthalmol Soc > Volume 59(9); 2018 > Article
Journal of the Korean Ophthalmological Society 2018;59(9):893-898.
DOI: https://doi.org/10.3341/jkos.2018.59.9.893    Published online September 15, 2018.
Two Cases of Orbital Apex Syndrome after Blunt Orbital Trauma.
Sang Cheol Yang, Hee Young Choi, Hyeshin Jeon
1Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea. lovcindy02@naver.com
2Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
외상 이후 발생한 안와첨증후군 2예
양상철1⋅최희영1,2⋅전혜신1,2
부산대학교 의과대학 안과학교실1, 부산대학교병원 의생명연구원2
Correspondence:  Hyeshin Jeon,
Email: lovcindy02@naver.com
Received: 5 April 2018   • Revised: 8 June 2018   • Accepted: 26 August 2018
Abstract
PURPOSE
To report two cases of orbital apex syndrome caused by blunt orbital trauma without structural damage of the orbit. CASE SUMMARY: (Case 1) A 50-year-old male came to our clinic complaining of visual loss after blunt orbital trauma by a metal bar. The best-corrected visual acuity was no light perception and light reflex was not observed in the affected eye. He also presented with complete ptosis and ophthalmoplegia with relative sparing of adduction and depression. High signal intensity of the orbital soft tissue including the optic nerve sheath was revealed using a T2-weighted image in magnetic resonance imaging. After starting steroid pulse therapy, his visual acuity improved to counting fingers on the third day. Ocular movement and levator function recovered to the normal range while visual acuity remained counting fingers. (Case 2) A 64-year-old female presented with complete ptosis after trauma to her right eyeball. The best-corrected visual acuity was 20/25 in the right eye. Complete ptosis and ophthalmoplegia with relative sparing of abduction and depression in the right eye were observed at the initial presentation. Magnetic resonance images showed enhancement of the right periphery optic nerve and distal rectus muscle. Two months after undergoing steroid pulse therapy, levator function and ocular movement recovered completely, and visual acuity improved to 20/20. CONCLUSIONS: The orbital apex syndrome caused by blunt orbital trauma showed good response to steroid pulse therapy. Steroid treatments may therefore be considered for the treatment of traumatic orbital apex syndrome.
Key Words: Blunt orbital trauma;Orbital apex syndrome


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