Orbital apex syndrome secondary to Sweet syndrome

Sweet syndrome (SS), or acute febrile neutrophilic dermatosis, is a dermatologic, auto-inflammatory disorder of unclear origin, often accompanied by systemic inflammation affecting various tissues, including the eyes. Common ocular manifestations include conjunctivitis but can extend to other ocular tissues. Orbital apex syndrome (OAS) involves damage to several cranial nerves transversing the orbital apex, leading to ophthalmoplegia and vision loss. This case report describes a rare case of OAS secondary to SS. A woman in her 50s with a history of SS presented with right eye loss of vision and ophthalmoplegia. Following treatment with high-dose systemic corticosteroids, her vision and ocular motility were restored. This case highlights the importance of recognising SS as a potential cause of OAS, especially when OAS is accompanied by the characteristic skin lesions noted in SS and that high-dose corticosteroids can treat this condition rapidly and effectively.