Orbital myositis: diagnosis and management

Curr Allergy Asthma Rep. 2009 Jul;9(4):316-23. doi: 10.1007/s11882-009-0045-y.


Orbital myositis is an inflammatory process that primarily involves the extraocular muscles and most commonly affects young adults in the third decade of life, with a female predilection. Clinical characteristics of orbital myositis include orbital and periorbital pain, ocular movement impairment, diplopia, proptosis, swollen eyelids, and conjunctival hyperemia. The most common presentation is acute and unilateral, which initially responds to systemic corticosteroid therapy. However, chronic and recurrent cases may involve both orbits. Many inflammatory, vascular, neoplastic, and infectious conditions that affect the extraocular muscles and other orbital tissue can mimic orbital myositis. The most important differential diagnoses include thyroid-related eye disease, other orbital inflammatory processes (unspecific idiopathic inflammation, vasculitis, and sarcoidosis), orbital cellulitis, and orbital tumors. In refractory, chronic, or recurrent cases, steroid-sparing agents, inmmunosuppressants, or radiation therapy may be indicated.

Publication types

  • Review

MeSH terms

  • Diagnosis, Differential
  • Eye / microbiology
  • Eye / pathology
  • Humans
  • Immunologic Factors / therapeutic use
  • Oculomotor Muscles / microbiology
  • Oculomotor Muscles / pathology
  • Oculomotor Muscles / physiology
  • Orbital Myositis / diagnosis*
  • Orbital Myositis / drug therapy*
  • Orbital Myositis / microbiology
  • Steroids / therapeutic use


  • Immunologic Factors
  • Steroids