Orbital apex syndrome secondary to myocysticercosis: a rare case report

Orbital apex syndrome secondary to myocysticercosis: A case report from Nepal

Introduction

Cysticercosis is caused by parasitic infestation mainly by the larval form of Taenia solium. Orbital cysticercosis may involve both the intraocular structures and orbit particularly the extraocular muscles. The clinical manifestations are caused mainly by the mass effect of the cyst in the initial period resulting in ocular motility restriction and proptosis and depends primarily on the site of the lesion.

Case presentation

Here we report a case of 27 years old male with orbital apex syndrome secondary to myocysticercosis.

Discussion

Orbital myocysticercosis often mimics various eye pathologies like as isolated nerve palsy, orbital pseudotumor, orbital cellulitis. Acute vision loss in a case of orbital cysticerosis is mainly due to compressive optic neuropathy due to cystic lesion of extra ocular muscle or by direct invasion of the optic nerve. In our case, MRI orbit revealed cysticercosis of lateral rectus at orbital apex where it compressed the optic nerve resulting compressive optic neuropathy. Albendazole along with steroid was used as the first-line treatment.

Conclusion

This case highlights that Orbital Apex Syndrome Secondary to Myocysticercosis is a rare and can lead to severe visual loss if not managed timely.

•

Cysticercosis is serious health problem in many developing countries of Asia like Nepal.

•

Orbital cysticersosis can be sight threatening so early diagnosis and intervention can prevent vision loss.

Cysticercosis in ophthalmology

Cysticercosis is caused by Taenia solium, a cestode or tapeworm that preferentially affects the subcutaneous tissue, brain, muscle, and the eye. It is traditionally a disease of low socioeconomic regions, but large-scale population migration has made it a matter of global concern. Its ocular invasion is a potentially blinding disease. In the last two decades, there has been considerable discussion of cysticercosis; however, most comes from a limited number of case observations. Thus, to overcome this limitation, we summarize and analyse twenty years of medical literature (from 2000 to 2020) on cysticercosis in ophthalmology.