Enigma of Red, Still Eye: Orbital Inflammatory Syndrome.

This article discusses a case of a 52-year-old male who presented with sudden onset nausea and vomiting, followed by acute left eye proptosis with redness. The patient also experienced left-sided second, third, fourth, and sixth nerve palsy, along with orbital pain and dimness of vision. After initial evaluation, a diagnosis of idiopathic orbital inflammatory syndrome (OIS) with orbital pseudotumor and orbital myositis was made. The patient was treated with intravenous pulse methylprednisolone and maintained on oral steroids. While the extra-ocular movements resolved completely, the patient's visual acuity remained compromised. OIS is a constellation of multiple idiopathic inflammatory involvement of several sites in the orbit, leading to various manifestations. Treatment typically involves steroids, but refractory cases may require steroid-sparing agents or radiation therapy. [Extracted from the article]