Abstract
Orbital pseudotumour is a common clinical condition w hich classically s hows d ramatic r esponse to steroid therapy. W e report a fatal case o f s teroid-respo nsive p ainful o phthalmoplegia w hich w as p roven to be due to fungal i nfection in post-mortal study. We c onclude that biopsy is still the k ey for making a confident a nd c omfortable d iagnosis. CASE R EPORT A 75-year-old diabetic man presented with left-sided temporal headache for 1 month. His left eye became red and painful with gradual deterioration of vision over 2 weeks. Glycaemic control was satisfactory after commencement of insulin 1 year previously. Examination of the left eye showed total blindness with chemosis, partial ptosis, and complete ophthalmoplegia. Intraocular pressure was 16 mmHg. Fundoscopy revealed intact optic discs and bilateral photocoagulation scars. The rest of the physical examination was unremarkable. He was
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