PMC3355651_01
a Extraocular movements prior to treatment, demonstrating an orbital apex syndrome. b Eye movements after 2 weeks of voriconazole therapy.
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F1
OD and 20/25 OS; his color vision tested with Ishihara plates was 1/11 OD and 11/11 OS. On examination, he had a trace right relative afferent pupillary defect, complete ptosis of the right lid, and a frozen right eye due to paralysis of cranial nerves III, IV, and VI (fig. 1a). He also showed a marked improvement in motility (fig. 1b).
MRI T1- (a) and T2-weighted (b) images from our patient, demonstrating an infiltrative process centered in the right pterygopalatine fossa and involving the adjacent soft tissues of the nasal posterolateral recess, right orbital apex, right sphenoid sinus, and dura of the clinoid process.
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F2
An MRI and CT of the head were ordered which demonstrated an infiltrative process centered in the right pterygopalatine fossa and involving the soft tissues of the nasal posterolateral recess, right orbital apex, right sphenoid sinus, and dura adjacent to the clinoid process (fig. 2).