Sudden Painful Loss of Vision – Exquisite Case of Tolosa Hunt Syndrome

Tolosa Hunt Syndrome is a painful ophthalmoplegia with periorbital or hemi cranial pain plus ipsilateral oculomotor nerve palsy with or without oculo-sympathetic paralysis. Many causes can lead to painful ophthalmoplegia like inflammatory, infective, neoplastic, vascular, etc. Various investigations need to be done to rule out the organic causes of painful ophthalmoplegia. Here we would like to report a case of Tolosa Hunt Syndrome in a 45-year-old female who was presented to our hospital with history of retro orbital pain followed by sudden loss of vision. Computed Tomography and Magnetic Resonance Imaging showed features suggestive of Tolosa Hunt Syndrome and she was treated with high dose steroids. The patient responded well to high dose steroids showing significant improvement in both vision and retro orbital pain.