Traumatic superior orbital fissure syndrome: Review of literature and report of three cases
A 38-year-old male suffered facial injury due to road traffic accident 12 days back. He was managed conservatively in a peripheral health center for head injury and was referred to the ophthalmology unit at our hospital. The diagnosis of SOFS was made by the ophthalmologist and the patient was further referred to the maxillofacial unit for opinion regarding facial fractures. On examination, there was bilateral circumorbital ecchymosis and subconjunctival hemorrhage. There was marked proptosis in the right eye []. The eyeball was fixed in a lateral gaze. Pupil was dilated with vision intact and there was complete absence of movement of eyeball in all the gazes []. Ophthalmic examination revealed loss of corneal reflex, loss of direct light reflex, presence of consensual reflex, and loss of accommodation reflex. On palpation, there was depression and tenderness over the zygomatic arch region with tenderness at the fronto-zygomatic suture and the infraorbital rim. A CT scan showed marked proptosis of the right eye with no intraconal or extraconal hemorrhage []. The patient was already on the regimen of megadose steroids prescribed by the ophthalmologist. There was partial improvement in the ptosis, proptosis, and ophthalmoplegia after 4 weeks. The patient was lost to further follow-up.