"Bitemporal occlusion, especially in elderly patients with
medial rectus impairment is not recommended as the partial patch may reduce the patient's peripheral vision and increase the risk of a fall.
Gadolinium-enhanced [T.sub.1] and [T.sub.2]-weighted MRI of the orbit revealed inflammation in bilateral extraocular muscles which was more pronounced in the left
medial rectus suggesting orbital myositis (Figures 3 and 4).
Given her atypical presentation, we got MRI of orbit with contrast done that revealed ill-defined mixed signal intensity lesion in the intraconal compartment of the left orbit involving
Medial Rectus, Inferior Rectus and posterior part of the Superior Rectus muscles.
Symptomatic excyclotorsion following inferior transposition of both
medial rectus muscles in patients with bilateral trochlear nerve palsy.
(3) have demonstrated a case of orbital metastasis of PTC to the
medial rectus muscle, similar to our case, in which muscles were involved.
Right
medial rectus muscle was hypertrophic and iso-hyperintense in T2, and contrast-enhanced, fat-suppressed T1-weighted images (Figure 1A, 1B, 1C, 1D).
In the second case,
medial rectus muscle swelling, lid retraction, and proptosis of the right eye and diplopia were observed [16].
The mass was located in the lateral orbit cavity extending to the ethmoid and maxillary sinuses, with bony destruction, encasing and displacing the
medial rectus and superior oblique muscles, optic nerve, ocular globe, and vascular structures (Figure 1).
Orbital computed tomography revealed a 1.5 x 2.9 x 1.5 cm rim-enhancing hypodense lesion at the right orbital apex abutting to the optic nerve sheath complex and right
medial rectus muscle (Figure 1).
It exists in complex with multiple independent subnuclei, controlling the superior, inferior, and
medial rectus muscle, inferior oblique muscle, levator palpebrae superioris muscle, and sphincter pupillae, respectively.
Most involve injury to the
medial rectus muscle via violation of the lamina papyracea, while the orbital floor and adjacent inferior rectus muscle is generally not considered a high-risk area [6].
