Objective:

This is the case of a male with a past medical history of squamous cell carcinoma (SCC) treated with surgery and radiotherapy who had loss of vision in his right eye due to vascular occlusion. Two weeks later he suffered from complete right ptosis and ophthalmoplegia. The suspected diagnosis—orbital apex syndrome (OAS)—was first ruled out by the imaging modalities, yet confirmed 1 month later by the disease clinical progression and a second magnetic resonance imaging.

Results:

The SCC has the capacity of local infiltration and distance dissemination. The OAS is characterized by the damage it causes to the structures that pass through the upper orbital fissure and optical channel

Conclusions:

The diagnosis of OAS is based on clinical suspicion and confirmation through imaging modalities. However, in cases with clear clinical signs and initial normal analytics and image findings, early treatment may improve the patient’s prognosis and quality of life.

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