Surgical Management of Extraocular Muscle Cysticercosis Causing Optic Foramen Syndrome

Extraocular muscle cysticercosis usually presents with proptosis and restriction of eyeball movements. However, it can cause vision loss by compression of the optic nerve at the optic foramen in infrequent circumstances. We report a rare case with an unusual manifestation of ptosis, proptosis, lateral rectus palsy, and acute vision loss in the right eye. Magnetic resonance imaging was suggestive of cysticercal cyst. Emergency optic nerve decompression with cyst excision was done. Treatment of choice for extraocular muscle cysticercosis presenting with restriction of eyeball movements is mainly medical, consisting of albendazole and steroids. However, as this lesion rarely causes vision loss, indications of surgical decompression of optic nerve are not well defined. We recommend that early surgical management should be done along with medical treatment in cases of vision loss caused by extraocular muscle cysticercosis.