Orbital abscess: management and outcome.
OBJECTIVE
To discuss the diagnosis, management and outcome of various types of orbital abscess.


METHODS
The medical records of 13 patients diagnosed and treated for orbital abscess were reviewed. The sources of infection included: paranasal sinusitis (n = 5), odontogenic origin of infection (n = 4), one each, temporal fossa abscess, palatal abscess, furuncle on the nose, and secondary to retrobulbar injection of steroid. Computed tomographic scans revealed the presence of an abscess in all 13 cases. Associated findings on CT scan included: sinus disease (n = 8), cavernous sinus thrombosis (n = 2) and subdural empyema (n = 2). All patients were treated with intensive, multiple, intravenous antibiotics and early surgical drainage.


RESULTS
Purulent material collected surgically from the orbit cultured Staphylococcus aureus (n = 3), two each Pseudomonas aeruginosa, Proteus mirabilis, Acinetobacter species and one each beta-haemolytic Streptococci, Citrobacter frundi and Enterobacter. Final visual acuity was good in 6 patients (6/12-6/6) and no light perception in 6 others. Visual acuity could not be recorded in the infant. The other complications were intracranial abscess (n = 4), cavernous sinus thrombosis (n = 2) and restricted ocular motility (n = 1).


CONCLUSIONS
A high index of suspicion is necessary, along with early institution of appropriate diagnostic imaging, and aggressive medical and surgical treatment for a favourable outcome in cases of orbital abscess.
Suneetha
N
N
Department of Ophthalmology, St. John's Medical College Hospital, Bangalore, India. ophthalaa.sjmc@vsnl.com
Battu
R R
RR
Thomas
R K
RK
Bosco
A
A
D000038:Abscess / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000000981:diagnostic imaging; D009916:Orbital Diseases / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D012189:Retrospective Studies; D013396:Suction; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014792:Visual Acuity
D000900:Anti-Bacterial Agents