Recurrent Eosinophilic Angiocentric Fibrosis Presenting as Compressive Optic Neuropathy in a 39-Year-Old Male: A Case Report

Eosinophilic angiocentric fibrosis (EAF) is a rare, slowly progressive fibrosing condition with a predilection for the upper respiratory tract, particularly the nasal cavity. Patients often present with nonspecific nasal symptoms and may experience rare ocular manifestations such as epiphora, diplopia, and proptosis. We report a case of a 39-year-old male who presented with sudden-onset vision loss, ptosis in right eye and diplopia, which was found to be associated with recurrent EAF leading to compressive optic neuropathy. Despite initial management with intravenous steroids, the patient showed no improvement and was subsequently treated with rituximab. This case highlights the importance of considering EAF in the differential diagnosis of orbital masses and emphasizes the role of immunosuppression in managing recurrent cases.