Orbital apex syndrome  has been described as a syndrome involving damage to the oculomotor nerve , trochlear nerve , abducens nerve , and ophthalmic branch of the trigeminal nerve  in association with optic nerve dysfunction.

The cavernous sinus syndrome  may include the features of an Orbital apex syndrome  with added involvement of the maxillary branch of the trigeminal nerve  and  oculosympathetic fibers. Cavernous sinus lesions are also more commonly bilateral.

The term superior orbital fissure syndrome or Rochon–Duvigneaud syndrome is often applied to lesions located immediately anterior to the orbital apex, including the structures exiting the annulus of Zinn and often those external to the annulus . In this clinical setting, multiple cranial nerve palsies may be seen in the absence of optic nerve pathology.

This patient has an inflammatory pseudotumor of the orbit giving the clinical signs of  superior orbital fissure syndrome

See patient's photos 3 weeks after medical ttt