A Painful Eye with Proptosis: What’s the Underlying Cause?

Case presentation A 59-year-old woman arrived at the emergency department with a week-long history of pain in her right eye, along with periorbital swelling and a sudden decline in vision. Medical history No history of injury, sinusitis, or stye No sinonasal complaints Myopia Previous right retinal detachment, surgically repaired with scleral buckling Initial examination Visual acuity (right eye): 6/48 Conjunctival chemosis, proptosis, and periorbital edema in the right eye Sclera appeared White Restricted abduction of the right eye Fundoscopy (Figure 1) – Tilted optic disc with retinal atrophy – Findings consistent with high myopia Figure 1 : An optical coherence tomography image of the patient's left retina; Source: Cureus Systemic examination Normal findings Apyrexial Laboratory findings C-reactive protein:72 mg/L Erythrocyte sedimentation rate: 64 mm/h White cell count: Normal…