Optic Nerve Cysticercosis at the Orbital Apex Presenting as Optic Neuritis

PURPOSE: To describe an unusual presentation of ocular cysticercosis and highlight the role of imaging in diagnosis. CASE REPORT: A 33-year-old female presented with loss of vision in her right eye and features suggesting optic neuritis. Magnetic resonance imaging (MRI) of the brain and orbits revealed a cystic lesion with peripheral rim enhancement in the optic nerve substance at the orbital apex. An enzyme-linked immunosorbent assay test for cysticercosis further established the diagnosis as optic nerve cysticercosis. She was treated with oral albendazole and steroids, resulting in remarkable improvement in visual acuity and resolution of the lesion. CONCLUSION: A high index of clinical suspicion along with appropriate imaging methods can help diagnose rare presentations of ocular cysticercosis. With timely management, successful outcomes can be obtained.