Journal List > J Korean Ophthalmol Soc > v.54(5) > 1009682

Gyu, Ae, Jung, and Hae: Orbital Cellulitis Following Strabismus Surgery

Abstract

Purpose

To report a case of sudden orbital cellulitis presenting 2 weeks after strabismus surgery in a patient who had pre-viously 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 re-vealed eyelid edema, chemosis, and subconjunctival hemorrhage of the left eye. The next day, eye movements were mod-erately 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 symp-tom aggravation and purulent discharge from the left conjunctival fornix. Culture of conjunctival fornices revealed pen-icillin-resistant staphylococcus aureus. Intravenous anitibiotics were maintained for 11 days additionally and left eye swel-ling, tenderness and ocular movement restrictions were improved. The patient was discharged from the hospital with a best corrected visual acuity of 0.2.

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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.
jkos-54-789f1.tif
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.
jkos-54-789f2.tif
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