Trochlear apparatus calcification

Case contributed by Himanshu Mishra
Diagnosis almost certain

Presentation

The patient, who had recovered from an episode of mild COVID-19 pneumonia three weeks ago, complained of nasal obstruction since two days. There was no history of trauma or any ocular symptoms.

Patient Data

Age: 20 years
Gender: Female

Non-contrast CT images (soft tissue and bony windows) show small foci of calcification on the superomedial aspects of both orbits. There is no evidence of proptosis, retrobulbar fat stranding, or sinus opacity. Bony orbits appear normal.

Case Discussion

The trochlea is a fibrocartilaginous structure attached to frontal bone located in the superomedial aspect of orbit that permits unimpeded movement of the superior oblique tendon and sheath. Calcification of the trochlear apparatus is a relatively common benign condition that is usually discovered incidentally. It may be confused with intraocular foreign body.

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