Neurotrophic Keratitis in Locally Advanced Nasopharyngeal Carcinoma

Nasopharyngeal carcinoma is a locally invasive malignant tumor that invades the orbit frequently. We came across a 65-year-old man with locally advanced nasopharyngeal carcinoma on chemotherapy with orbital invasion causing total ophthalmoplegia, loss of corneal sensations, and ptosis. He also had a...

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Main Authors: Madhurima A Nayak, Sunayana Bhat, Sripathi Kamath B, Akshata Charlotte
Format: Article
Language:English
Published: Light House Polyclinic Mangalore 2025-04-01
Series:Online Journal of Health & Allied Sciences
Subjects:
Online Access:https://www.ojhas.org/issue93/2025-1-10.html
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author Madhurima A Nayak
Sunayana Bhat
Sripathi Kamath B
Akshata Charlotte
author_facet Madhurima A Nayak
Sunayana Bhat
Sripathi Kamath B
Akshata Charlotte
author_sort Madhurima A Nayak
collection DOAJ
description Nasopharyngeal carcinoma is a locally invasive malignant tumor that invades the orbit frequently. We came across a 65-year-old man with locally advanced nasopharyngeal carcinoma on chemotherapy with orbital invasion causing total ophthalmoplegia, loss of corneal sensations, and ptosis. He also had a central neurotrophic keratitis with hypopyon. Based on these findings, a diagnosis of left-sided superior orbital fissure syndrome with neurotrophic keratitis was made. CT scan of the head revealed a soft-tissue mass abutting the superior aspect of the orbit and cavernous sinus and tumor recurrence was confirmed. We started the patient on topical fortified antibiotics and Atropine after placing a bandage contact lens. He was advised palliative radiotherapy by the medical oncologist. In two months, there was marked improvement in ocular motility, ptosis, and redness. The ulcer had healed by the formation of a central macular opacity. Corneal sensations had returned. This case exemplifies the reversible nature of superior orbital fissure syndrome and associated corneal anesthesia. As the tumor is radiosensitive, the mass effect of the tumor was reduced leading to the resolution of ophthalmoplegia and healing of the ulcer.
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publisher Light House Polyclinic Mangalore
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spelling doaj-art-ab824c41f41a4e79ab09634918ceed112025-08-20T02:17:28ZengLight House Polyclinic MangaloreOnline Journal of Health & Allied Sciences0972-59972025-04-01241Neurotrophic Keratitis in Locally Advanced Nasopharyngeal CarcinomaMadhurima A Nayak0Sunayana Bhat1Sripathi Kamath B2Akshata Charlotte3Assistant Professor, Department of Ophthalmology, Father Muller Medical College, Mangaluru, India.Professor, Department of Ophthalmology, Father Muller Medical College, Mangaluru, India.Associate Professor, Department of Ophthalmology, Father Muller Medical College, Mangaluru, India.Assistant Professor, Department of Ophthalmology, Father Muller Medical College, Mangaluru, India.Nasopharyngeal carcinoma is a locally invasive malignant tumor that invades the orbit frequently. We came across a 65-year-old man with locally advanced nasopharyngeal carcinoma on chemotherapy with orbital invasion causing total ophthalmoplegia, loss of corneal sensations, and ptosis. He also had a central neurotrophic keratitis with hypopyon. Based on these findings, a diagnosis of left-sided superior orbital fissure syndrome with neurotrophic keratitis was made. CT scan of the head revealed a soft-tissue mass abutting the superior aspect of the orbit and cavernous sinus and tumor recurrence was confirmed. We started the patient on topical fortified antibiotics and Atropine after placing a bandage contact lens. He was advised palliative radiotherapy by the medical oncologist. In two months, there was marked improvement in ocular motility, ptosis, and redness. The ulcer had healed by the formation of a central macular opacity. Corneal sensations had returned. This case exemplifies the reversible nature of superior orbital fissure syndrome and associated corneal anesthesia. As the tumor is radiosensitive, the mass effect of the tumor was reduced leading to the resolution of ophthalmoplegia and healing of the ulcer.https://www.ojhas.org/issue93/2025-1-10.htmlneurotrophic keratitisnasopharyngeal carcinomasuperior orbital fissure syndrome
spellingShingle Madhurima A Nayak
Sunayana Bhat
Sripathi Kamath B
Akshata Charlotte
Neurotrophic Keratitis in Locally Advanced Nasopharyngeal Carcinoma
Online Journal of Health & Allied Sciences
neurotrophic keratitis
nasopharyngeal carcinoma
superior orbital fissure syndrome
title Neurotrophic Keratitis in Locally Advanced Nasopharyngeal Carcinoma
title_full Neurotrophic Keratitis in Locally Advanced Nasopharyngeal Carcinoma
title_fullStr Neurotrophic Keratitis in Locally Advanced Nasopharyngeal Carcinoma
title_full_unstemmed Neurotrophic Keratitis in Locally Advanced Nasopharyngeal Carcinoma
title_short Neurotrophic Keratitis in Locally Advanced Nasopharyngeal Carcinoma
title_sort neurotrophic keratitis in locally advanced nasopharyngeal carcinoma
topic neurotrophic keratitis
nasopharyngeal carcinoma
superior orbital fissure syndrome
url https://www.ojhas.org/issue93/2025-1-10.html
work_keys_str_mv AT madhurimaanayak neurotrophickeratitisinlocallyadvancednasopharyngealcarcinoma
AT sunayanabhat neurotrophickeratitisinlocallyadvancednasopharyngealcarcinoma
AT sripathikamathb neurotrophickeratitisinlocallyadvancednasopharyngealcarcinoma
AT akshatacharlotte neurotrophickeratitisinlocallyadvancednasopharyngealcarcinoma