Superior Orbital Fissure Syndrome VS Orbital Apex Syndrome

Symptoms of superior orbital fissure syndrome include:

1. Pupillary dilation via alteration in cranial nerve III function in it’s innervation of the pupillary constrictors.
2. Paresis of cranial nerves III, IV, and IV causing ophthalmoplegia.
3. Cranial nerve III involvement causes paresis of the levator palpebrae superiorus muscle, leading to ptosis and loss of the superior palpebral fold.
4. Neurosensory disturbance to the CN V1 with hypesthesia of the supraorbital and supratrochlear nerves and loss of the corneal reflex.
5. Proptosis from engorgement of the ophthalmic vein and lymphatics.
6. The orbital apex syndrome includes all of the above plus optic nerve involvement, leading to changes in visual acuity.