PROGRESSIVE VISUAL-LOSS AND MOTILITY DEFICIT

A 63-year-old female with known stage III, low grade non-Hodgkin's lym phoma presented with progressive visual loss in the left eye and binoc ular diplopia in all positions of gaze. The left globe was almost immo tile. Two MRI's of the orbit were interpreted as normal. Lumbar punctu re did net reveal abnormal cytology. Although orbital apex involvement is uncommon in non-Hodgkin's lymphoma, the patient's clinical finding s clearly indicated a lesion in this area, which was confirmed by a th ird MRI. Review of one of the initial films showed evidence of orbital apex involvement. To prevent diagnostic delay and unnecessary repeat imaging, che clinical diagnosis of orbital apex syndrome should be cle arly communicated to the radiologist. Prompt recognition of orbital ap ex syndrome may improve visual outcome. (C) 1997 by Elsevier Science I nc. All rights reserved.