Internal ophthalmoplegia resulting from acute orbital phycomycosis

Area of Science:

• Ophthalmology
• Mycology
• Infectious Diseases

Background:

• Phycomycosis is a rapidly fatal opportunistic fungal infection primarily affecting immunocompromised individuals.
• Early diagnosis and treatment are critical due to its high mortality rate.
• Rhino-orbital-cerebral phycomycosis involves the eyes and orbits, often presenting with orbital apex syndrome.

Observation:

• This report details a rare case of phycomycosis presenting solely with internal ophthalmoplegia.
• The patient's symptoms suggest involvement at the orbital apex.
• The presentation was not extensive enough to meet the criteria for complete orbital apex syndrome.

Findings:

• Internal ophthalmoplegia can be an isolated manifestation of phycomycosis affecting the orbital apex.
• This finding expands the spectrum of clinical presentations for orbital phycomycosis.
• The case underscores the need for vigilance in diagnosing fungal infections in at-risk patients.

Implications:

• Recognizing isolated internal ophthalmoplegia is crucial for prompt diagnosis and management of phycomycosis.
• This case may prompt a re-evaluation of diagnostic criteria for orbital involvement in fungal infections.
• Further research is needed to understand the varied presentations of phycomycosis in the orbit.