DR. HARSHITA HIRAN

Dr. GLADYS RODRIGUES, DR. TEENA MARIET MENDONCA

Abstract

36 year old diabetic male post renal transplant admitted for Covid 19 was referred for drooping of right upper lid with severe pain.Visual acuity was 6/6, N6. On examination,fullness of right upper lid with moderate ptosis and restriction of elevation was noted. Pupillary reactions and fundus was normal. MRI brain showed soft tissue thickening along anterior, superior and lateral orbital region, suggestive of early orbital cellulitis.Patient was started on intravenous antibiotics but showed no improvement so repeat orbital MRI was advised which showed bulky right lacrimal gland with preseptal soft tissue thickening. Systemic steroids were started following which patient improved dramatically. Mucormycosis being first differential in covid patient with ptosis, this case highlights importance of looking for other causes in atypical presentation.Presence of pain is not typical feature of mucormycosis.Dacryoadenitis has varied presentation and can be cause of ptosis post viral infections.