Not all orbital inflammations in the COVID-19 era are due to mucormycosis – A case of orbital pseudotumour leading to vision loss

Abstract

A 57-year-old male patient with type 2 diabetes mellitus who had survived severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) disease (COVID-19) presented with loss of vision in the right eye (RE) of 20-day duration. The patient had been diagnosed elsewhere with orbital mucormycosis and had been treated for it. The patient developed vision loss in RE 1 week after the initiation of treatment. At the time of presentation in our institute, vision in RE had reduced to no perception of light. Examination showed a relative afferent pupillary defect and pale optic disc in RE. Gadolinium-enhanced contrast magnetic resonance imaging of the brain, orbit and paranasal sinuses suggested perineuritic type of idiopathic orbital inflammation. In the present COVID-19 scenario, diagnosis other than mucormycosis should be kept in mind when dealing with cases of orbital inflammation.