DR. ZEBA SHAIKH

Dr. MATHU KRISHNAN VALLINAYAGAM

Abstract

Rhino orbital mucormycosis is a condition seen in patients with poor diabetic control. A 72-year-old male with no known comorbidities, presented with right orbital apex syndrome (OAS). Patient presented with periorbital edema, mild ptosis, chemosis and restriction of extra-ocular muscle movements. On examination of oral cavity an eschar was found on hard palate. On investigation, patient was found to have deranged glycemic profile. CT scan brain showed pan sinus mucosal thickening with mild hyperdense soft tissue. After adequate glycemic control emergency functional endoscopic sinus surgery (FESS) was performed. Histopathological examination showed necrosis with multiple broad based, aseptate hyphal elements with irregular branching and hemorrhage, suggestive of mucormycosis. Early recognition of OAS along with eschar, timely investigations, curative FESS and post-operative treatment with amphotericin-b helps to reduce ocular morbidity.