NYMC Faculty Publications

Orbital Apex Inflammation: A Curious Case of COVID-19

Author Type(s)

Faculty

DOI

10.5693/djo.02.2022.05.001

Journal Title

Digital Journal of Ophthalmology

First Page

69

Last Page

73

Document Type

Article

Publication Date

1-1-2022

Department

Ophthalmology

Second Department

Radiology

Abstract

A 25-year-old man presented to an urgent care facility with sudden loss of vision in his right eye, diplopia, and anosmia. He tested positive by reverse-transcription polymerase chain reaction for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Nine days later, he presented at our emergency department, at which time ophthalmic examination revealed reduced visual acuity in the right eye, with poor color vision and a relative afferent pupillary defect. He had a moderate adduction deficit and mild hypertropia of the right eye, with an intermittent exotropia. Magnetic resonance imaging of the orbits revealed asymmetric, abnormal enhancement of the right optic nerve sheath extending to the right orbital apex. His ocular symptoms resolved completely with systemic steroids. All infectious and inflammatory labs returned negative except for COVID-19. Ocular findings have been consistently implicated throughout this pandemic. This case highlights an unidentified presentation with optic nerve involvement and orbital inflammation.

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