Dr.SREELAKSHMI S

Dr.Teena Mariet Mendonca, Dr.Rajesh Nayak, Dr.SHOBHA G. PAI

Abstract

Orbital myositis is a subtype of Idiopathic orbital inflammatory disease with primary involvement of the extraocular muscles. It is an important differential for painful ophthalmoplegia and can mimic orbital cellulitis. A 68year old male, uncontrolled diabetic presented with painful proptosis of Right eye since 2weeks. He had cataract surgery in the same eye 2 months back. Uncorrected visual acuity was 6/36 in Right eye and 6/9 in left eye. On examination he had marked lid edema, chemosis and total ophthalmoplegia in Right eye. Pupillary reactions and fundus examination were normal. Patient was presumed for orbital cellulitis and was empirically started on broad spectrum iv antibiotics elsewhere and did not show any clinical improvement. CT orbit showed fusiform enlargement of right medial rectus with adjacent fat stranding suggestive of isolated myositis. Patient was then started on IV steroids and improved dramatically.