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  • Title: Orbital presentation of systemic vasculitis: a diagnostic and management challenge.
    Author: Singh M, Singh U, Zadeng Z.
    Journal: Nepal J Ophthalmol; 2015; 7(1):65-8. PubMed ID: 26695609.
    Abstract:
    BACKGROUND: Orbital involvement in Wegener's Granulomatosis (WG) is rare and has an overall good prognosis. CASE: A 60-year-old hypertensive Indian female presented with vision loss and painful proptosis of left eye. Orbital incisional biopsy suggested necrotising small vessel inflammation. The saddle nose deformity and pedal nodulo- ulcerative lesions further consolidated the diagnosis of Wegener's granulomatosis. Systemic immunosuppressant provided remission and the only relapse was managed successfully with intravenous Rituximab. CONCLUSION: Wegener's granulomatosis should be kept in the differential diagnosis of painful proptosis with a diffuse orbital mass in an elderly patient presenting with profound vision loss. Newer immune modulating agents are useful adjuncts in preventing relapses of this fatal disease.
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