DR. SRAVANI REDDY SANEPALLI

DR. AMIT RAJ, DR.PRERNA SINHA, DR. PRABHAKAR SINGH

Abstract

A 70 year male recovered from COVID pneumonia presented with complains of sudden diminution of vision in left eye along with drooping of upper lid & forward protrusion of left eye for 7days.Examination revealed clinical picture of left orbital apex syndrome.Fundoscopy showed white out retina with box carring of blood vessels.Diagnostic Nasal Endoscopy showed eschar in the middle meatus & KOH mount revealed broad aseptate hyphae.Contrast Enhanced-MRI orbit&PNS showed changes suggestive of rhino-orbital mucormycosis.The patient had undergone extensive debridement of paranasal sinuses along with I.V Liposomal Amphoterecin-B(LAMB) and 3 Transcutaneous retrobulbar-B(TRAMB) injections.After 3 doses of TRAMB ,the patient had improvement in extraocular movements, ptosis & proptosis.The mainstay of mucormycosis being surgical debridement and I.V. LAMB.This case emphasizes the role of TRAMB in the conservative management of orbital mucormycosis & halting the intracranial spread.