Dr.DEBOLINA DEB, D21510
A 46 year old diabetic and hypertensive with Right LMN type Facial nerve palsy was examined 10 days back. Her BCVA right eye was 6/18 for distance and N6 for near, left eye was 6/12 for distance and N6 for near. Right eye had mild proptosis, lagophthalmos, lid lag, intact corneal sensation and good bell’s phenomenon. Left eye anterior segment was normal. Both pupils were normal, pseudophakic, normal intraocular pressure and fundus. 10 days later patient was reviewed in ICU with right ear Malignant Otitis Externa. Right eye had proptosis, lagophthalmos, lid lag and no corneal sensation. Left eye anterior segment was normal. Both eyes abduction were limited. Pupils were normal. Dilated fundus examination showed disc oedema, blurred disc margins and disc haemorrhages in both eyes.
A provisional diagnosis of Cavernous Sinus involvement with Right 5th and 7th and bilateral 6th cranial nerve palsies, possibly from ear infection, has been made.
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