An 88-year-old woman with a blind painful OS underwent a retrobulbar alcohol injection. Nine months following the procedure, she was evaluated in the clinic for discomfort surrounding her left brow and forehead and was found to have dysesthesia in the left V1 nerve distribution. There was no evidence of orbital inflammation on history or ocular examination. An MRI of the orbits showed intraconal abnormal signal with enhancement and enophthalmos. The chronic effect of retrobulbar alcohol injection on the orbital contents may mimic orbital inflammatory disease on the MRI, but the absence of clinical correlates should allow for appropriate diagnosis.