Orbital cysticercosis

Abstract

A young male patient presented to our ocular emergency department with chief complaints of progressive pain, redness, diplopia and a right-sided face turn. Ocular examination revealed severely restricted extraocular movements along with retinal folds in the left eye. Initial orbital ultrasound and CT findings were equivocal; however, serology favoured an infective cause. Considering the endemicity of the disease and equivocal investigation findings, a diagnosis of orbital cysticercosis with an atypical presentation was made. The patient was managed medically with a combination of oral albendazole and steroids over a period of 6 weeks to achieve optimal results.

Keywords: medical education; medical management; ophthalmology.

Figure 1

Nine gaze clinical pictures revealing an exodeviation in the primary gaze with restriction of adduction, elevation and depression in the presence of moderate ptosis.

Figure 2

(A) Axial sections of CT showing extensive fairly well-defined mass lesion extending from the orbital apex to just anterior to the orbital rim. Lateral rectus muscle could not be made out. (B) Scan ultrasound showing extensively thickened lateral rectus muscle with a large hypoechoic area within.

Figure 3

At the end of 8 weeks, there was an improvement in ptosis along with significant improvement in extraocular motility.

Figure 4

B-scan ultrasound at the end of 8 weeks showed significantly reduced lateral rectus muscle thickness.