Orbital Apex Inflammation

A wide variety of pathologic processes can involve the structures located at the apex of the orbit. In particular both noninfectious inflammations and infections can cause an orbital apex syndrome. Noninfectious inflammations include sarcoidosis, various vasculitides such as Wegener’s granulomatosis and giant cell (temporal) arteritis, and idiopathic orbital inflammation including immunoglobulin G4 (IgG4)-related disease. Infections may be caused by fungi, bacteria, viruses, spirochetes, and even parasites. The management of an orbital apex syndrome caused by inflammation depends on whether the inflammation is infectious or noninfectious as well as on the specific agent causing the syndrome.