Management of a blinding orbital apex cyst in a 14-year-old girl

This study was conducted to highlight the diagnostic and management challenges of orbital apex lesions. It is a retrospective report of a 14-year-old female who presented with no perception of light vision in her left eye following a 1-year history of left unilateral axial proptosis. Her computed tomography scan revealed a mass surrounding the optic nerve which was reported to be an optic nerve glioma. She had lateral orbitotomy and a cystic mass was dissected and excised. Systemic steroids and antibiotics were administered. Visual recovery was achieved in the immediate postoperative period. At discharge, her visual acuity was counting finger in the left eye. Visual recovery in the orbital apex lesions is possible if the patient is diagnosed early and managed promptly but delayed presentation and diagnostic challenges could lead to irreversible blindness.