Orbital Myositis

A 43-year-old Mongolian woman who had intermittent pain and swelling around her left eye for over a year. The symptoms had recently increased to the point that she was constantly in pain. She slept poorly at night and was not able to perform her household and childcare chores during the day. She had taken aspirin intermittently without relief of her symptoms. She presented to the government hospital outpatient clinic and was given a supply of ibuprofen. This lessened her pain somewhat, but she was generally incapacitated and sought help at a facility in another city. Examination in the eye department showed marked temporal conjunctival and episcleral injection of the left eye with mild lid swelling. The vision was reduced to 20/60 in that eye while the right eye was measured at 20/30. She had a 10-prism diopter left esotropia with increased pain on looking to the left. Slit-lamp examination of the left eye showed a clear cornea and a deep anterior chamber with mild flare but no cells. Fundus examination showed a clear vitreous cavity and some possible thickening of the temporal retinochoroidal layer.