Orbital apex syndrome secondary to nasopharyngeal carcinoma

We report the rare occurrence of unilateral orbital apex syndrome with neurotrophic keratitis secondary to nasopharyngeal carcinoma in the left eye in a 40-year-old lady. The patient presented with complaints of left-sided headache, loss of smell sensation, defective vision, and restriction of movements and drooping of left upper lid of one year duration. Computed tomography revealed hyperdense lesion involving left nasal cavity, nasopharynx and oropharynx, extending to left maxillary, sphenoid and ethmoid sinuses. Magnetic resonance imaging also confirmed the same.