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October 1940


Arch Ophthalmol. 1940;24(4):731-741. doi:10.1001/archopht.1940.00870040117009

We wish to call the attention of ophthalmologists to the orbital apex-sphenoid fissure syndrome which, though not rare, has not yet been described in the American ophthalmologic literature under this title so far as we know. Patients with this syndrome seek the aid of the ophthalmologist, and if the symptoms are not correctly interpreted, an intracranial lesion may be assumed to be present.

The syndrome is due to an inflammatory, neoplastic or traumatic process involving the nerves going through the sphenoid fissure : the third, fourth and sixth cranial nerves, the ophthalmic branch of the fifth cranial nerve, sympathetic fibers and the optic nerve at the orbital apex. This causes an impairment of vision of varying degrees, depending on the amount of pressure on the optic nerve. Defects of the visual field will depend on the same factor. The ophthalmoscopic findings may vary from the normal to marked optic neuritis and