A Case Study on Idiopathic Orbital Pseudotumor: Surgery and Steroid Treatment

This is a case study of five isolated orbital nerve inflammatory pseudotumor cases presenting with protrusion and visual acuity of the right eye. Optic disk edema was observed by ophthalmoscopy. Plain and contrast-enhanced magnetic resonance imaging (MRI) were used to examine the orbital fat and enlargement of the right optic nerve sheath along with orbital magnetic resonance imaging diagnostic test. The visual acuity (VA) of all the admitted patients was 1.5/20. All the patients reported attacks of retrobulbar pain and severe headache at fairly regular intervals. The patients on clinical examination were found to have protrusion, reduced visual acuity of the right eye with an ipsilateral afferent pupillary defect. There was no motility of the right eye and the exophthalmos of the right part was 27 mm. On examination, patients were diagnosed to have idiopathic orbital inflammation and received steroid therapy for 6 months. Thereafter, patients received surgical treatment to remove the superior wall of the orbit followed by cortisone therapy for a further 6 months. The follow-up examination of the patients for one year revealed a gradual improvement in the vision of all the patients. The VA of the right eye for all the patients was 6/20, and the exophthalmos was now around 19 mm. Thus, a dramatic response to surgery and steroid treatment was observed in all the patients.

Keywords
Orbital fat; Visual acuity; Optic disk edema; Optic nerve; Cortisone therapy