Starting at the time he was diagnosed with COVID 19, patient described a pulsating sensation in his right eye accompanied by blurry vision that progressed to diplopia and color desaturation. Patient did not have any recent trauma to his eye. Exam was notable for a right afferent pupillary defect (APD) and the inability to adduct the right eye. Fundi were normal, but he had decreased visual acuity of the right eye. Of note, the patient had a known history of left eye injury with chronic visual impairment. The rest of his cranial nerve exam was intact. MRI brain and orbits with and without contrast showed asymmetric abnormal enhancement in the right optic nerve sheath complex near the orbital apex concerning for inflammatory or infectious process. Extensive testing for infectious, inflammatory, demyelinating, vascular, and neoplastic etiologies were negative, including lumbar puncture. In consultation with ophthalmology and infectious disease, it was presumed that the patient developed an inflammatory orbital apex syndrome in the setting of COVID-19. He was treated with a five day course of high dose steroids after which he noted a significant improvement in visual acuity, color saturation, adduction, and diplopia.