Radiation induced tissue necrosis mimicking orbital apex syndrome

We are reporting a unique case with findings resembling orbital apex syndrome due to radiation-induced ischemic tissue necrosis following the treatment of meningiomatosis. In our patient, radiation injury caused multiple neuropathies including: 2nd, 3rd, 4th, 5th, and 6th neuropathies with oculosympathetic pathway involvement. To our knowledge, our patient has some unique features of complications related to radiation necrosis. Describing this case will help clinicians to have a better understanding of the extent of ocular manifestations secondary to radiation necrosis.