J Korean Ophthalmol Soc.  2013 May;54(5):789-793. 10.3341/jkos.2013.54.5.789.

Orbital Cellulitis Following Strabismus Surgery

• Kim GA
• Kwak AY
• Choi JB
• Park HS

• KMID: 2217047
• DOI: http://doi.org/10.3341/jkos.2013.54.5.789

Abstract

PURPOSE
To report a case of sudden orbital cellulitis presenting 2 weeks after strabismus surgery in a patient who had previously undergone retinal surgery for rhegmatogenous retinal detachment.
CASE SUMMARY
A 45-year-old male visited the ophthalmology clinic with a 3-day history of left eye pain and lid swelling which suddenly developed 2 weeks after left lateral rectus muscle recession surgery for secondary sensory exotropia. The patient had undergone trans pars plana vitrectomy twice, scleral encircling, oil injection and removal for rhegmatogenous retinal detachment 1.3 years prior. His best corrected visual acuity was 0.2 in his left eye and physical examination revealed eyelid edema, chemosis, and subconjunctival hemorrhage of the left eye. The next day, eye movements were moderately restricted. Computed tomography scanning with contrast enhancement demonstrated diffuse periorbital soft tissue swelling and enhanced fat stranding suggesting left orbital cellulitis. The patient was hospitalized with intravenous broad spectrum antibiotics. He was discharged after a 5-day course of intravenous antibiotic treatment, but readmitted for symptom aggravation and purulent discharge from the left conjunctival fornix. Culture of conjunctival fornices revealed penicillin-resistant staphylococcus aureus. Intravenous anitibiotics were maintained for 11 days additionally and left eye swelling, tenderness and ocular movement restrictions were improved. The patient was discharged from the hospital with a best corrected visual acuity of 0.2.

Keyword

Orbital cellulitis; Strabismus surgery

MeSH Terms

Anti-Bacterial Agents
Edema
Exotropia
Eye
Eye Movements
Eye Pain
Eyelids
Hemorrhage
Humans
Male
Muscles
Ophthalmology
Orbit
Orbital Cellulitis
Physical Examination
Retinal Detachment
Retinaldehyde
Staphylococcus aureus
Strabismus
Visual Acuity
Vitrectomy
Anti-Bacterial Agents
Retinaldehyde

Figure

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  Figure 1. External photograph of the 45 year-old man with a history of scleral encircling developing orbital cellulitis two weeks after strabismus surgery.

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  Figure 2. Axial CT scan of orbit showing signs of left orbital cellulitis. CT scan demonstrates diffuse swelling of periorbital soft tissue enhanced with contrast.

Reference

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