Blindness or loss of vision indicates involvement of the orbital apex, which is more serious, requiring urgent surgical intervention.

MRI (magnetic resonance imaging) provides more sensitivity in the evaluation of the cavernous sinus and the orbital apex.

Typically, if blindness is present with superior orbital syndrome, it is called orbital apex syndrome.

With enlargement of the extraocular muscle at the orbital apex, the optic nerve is at risk of compression.

This syndrome is a separate entity from Rochon-Duvigneaud syndrome, which occurs due to a lesion immediately anterior to the orbital apex.

Tumor invades any of the following: orbital apex, dura, brain, middle cranial fossa, cranial nerves other than (V2), nasopharynx, or clivus.

These nerves, with the exception of CN V, pass through the cavernous sinus to enter the orbital apex through the superior orbital fissure.

Orbital apex syndrome, also known as Jacod syndrome, is a collection of cranial nerve deficits associated with a mass lesion near the apex of the orbit of the eye.

It is less reliable than the CT scan and magnetic resonance imaging (MRI), however, to assess the extraocular muscle involvement at the orbital apex, which may lead to blindness.

The optic nerve lies just above and outside the cavernous sinus, superior and lateral to the pituitary gland on each side, and enters the orbital apex via the optic canal.