Acute orbital myositis.

We examined 9 consecutive cases of unilateral orbital myositis (7 women and 2 men; age range 15-46 years) presenting to Casualty. Only 3 were correctly diagnosed on the first visit. Eight patients exhibited globe retraction in the acute stages and, after treatment with systemic steroids, all made a full recovery. None of the patients had associated systemic disease and all remain well over a 6-12 month follow-up period. Orbital myositis may be a more common condition than previously thought; it can present with a variety of clinical signs, and may be difficult to diagnose in the early stages. The presence of globe retraction on movement of a painful, injected eye is a useful diagnostic sign which indicates inflammation of extraocular muscles and is present in the acute stages of the disease; we explain how to elicit globe retraction and suggest a management protocol for these patients.