Inflammatory bowel disease (IBD) is an autoimmune inflammatory condition of the gastrointestinal tract and encompasses 2 major subtypes: Crohn's disease and ulcerative colitis. Orbital myositis is an uncommon ophthalmic extraintestinal manifestation of IBD and may be associated with an internal necrotic collection. The presence of a necrotic collection in orbital myositis narrows the diagnostic differential to several infectious and noninfectious etiologies. The distinction between an infectious and noninfectious etiology is of significant therapeutic consideration, as management differs greatly. We present a case of a 17-year-old female presenting with a left lateral rectus orbital myositis associated with an internal necrotizing collection of the left lateral rectus. Histopathology demonstrated severe nonspecific chronic orbital myositis with features suggestive of focal granulomatous inflammation. She had an elevated fecal calprotectin and proceed to a colonoscopy, ultimately confirming a diagnosis of Crohn's disease. She was subsequently commenced on oral azathioprine and an oral prednisolone tapering course with ongoing follow-up. Her orbital disease remains quiescent at 6 months following her diagnosis.

ABSTRACT Background Orbital myositis (OM) is a subgroup of idiopathic orbital inflammation. It can involve single or multiple extraocular muscles and result in restriction or paresis of extraocular muscles. Method We reported two unusual cases of extraocular muscle paresis in the fibrotic stage of chronic OM and reviewed the literature related to this finding. Results The first case was of a 38-year-old woman with chronic OM with large-angle right eye exotropia and right medial rectus paresis. She received a botulinum A toxin injection into the right lateral rectus muscle as a first treatment, but it was unsuccessful in correcting her deviation. Subsequently, she underwent two strabismus surgeries, which successfully resolved her diplopia in primary gaze. The second case was of a 35-year-old woman with chronic OM and left lateral rectus palsy, which was managed with a botulinum A toxin injection. Conclusion OM can cause extraocular muscle palsy in the chronic fibrotic stage of the disease.

Treatment of chronic orbital myositis with daclizumab

Treatment of chronic orbital myositis with daclizumab

Treatment of recalcitrant idiopathic orbital inflammation (chronic orbital myositis) with infliximab

Chronic Orbital Myositis: Its Diagnostic Difficulties and Pathology

The purpose of this paper is threefold : first, to call attention to a comparatively rare type of chronic inflammation of the extraocular muscles known as idiopathic or primary chronic orbital myositis ; second, to suggest a simple test for its detection, and, third, to report 4 cases studied at the Institute of Ophthalmology, Presbyterian Hospital, New York. By way of introduction it may be stated that chronic inflammatory or degenerative changes in the extraocular muscles have been reported in the following conditions: (1) syphilis of the orbit; (2) tuberculosis of the orbit; (3) myasthenia gravis, muscular dystrophies and degenerative myositis of fatty, amyloid, vascular or traumatic origin; (4) exophthalmic goiter, before and after thyroidectomy, and (5) apparent good health (idiopathic form). Because of the rarity of syphilitic and of tuberculous orbital myositis and the ease with which the correct diagnosis can usually be made, no attempt will be made to discuss