deletions | additions       diff --git a/Acute Ischemic Optic Neuropathy in Rhinocerebral Mucormycosis.md b/Acute Ischemic Optic Neuropathy in Rhinocerebral Mucormycosis.md  index 08e411c..bc036ee 100644  --- a/Acute Ischemic Optic Neuropathy in Rhinocerebral Mucormycosis.md  +++ b/Acute Ischemic Optic Neuropathy in Rhinocerebral Mucormycosis.md 
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We desceribe three patients who presented with acute vision loss due to optic nerve infarction secondary to rhinocerebral mucormycosis.  Case 1  A 48-year-old diabetic male presented with pain and swelling in left orbital region since one week. The patient was in altered sensorium with GCS of 8 (E3V2M3) and right hemiplegia. Ophthalmology examination revealed diffuse bilateral chemosis, periorbital and lid edema, as well as nonreactive pupils, 7mm on the right and 2mm on the left. Fundus examination demonstrated bilateral fundal pallor. MR imaging of brain and orbits was done which revealed large acute left MCA territory infarct. In addition to this the axial DWI images showed restricted diffusion involving the intraorbital segment of left optic nerve consistent with acute optic nerve infarction. The ADC values were 0.372 x 10-3mm2/s in the involved segment of left optic nerve. The right optic nerve was normal on DWI and no altered signal intensity was appreciated in the optic nerves on T1 and T2 weighted images. Enhancing soft tissue was seen in the left maxillary and fronto-ethmoid sinuses with retro orbital fat stranding, bulky extraocular muscles suggesting sinus and orbital cellulitis. 3 D TOF MRA showed diffuse narrowing of the intracranial left ICA with complete occlusion of left MCA and its cortical branches. Patient was started on empiric amphotericin therapy. Nasal scrapings obtained at the time of admission revealed mucormycosis. There was gradual improvement in general condition of patient however the vision loss was permanent. permanent  MM00398677 MUCORMYCOSIS  CASE 2