Intraorbital heroin injection resulting in orbital cellulitis and superior ophthalmic vein thrombosis.
A 47-year-old man with decreased vision, ophthalmoplegia, proptosis, and chemosis of his right eye admitted to injecting heroin directly into his orbit. He was placed on intravenous antibiotics for orbital cellulitis, and computed tomography and magnetic resonance imaging were performed. Superior ophthalmic vein thrombosis (SOVT) was noted on magnetic resonance imaging. The patient responded well to intravenous antibiotics, and his symptoms resolved with minimal deficits. Steroids and anticoagulants were not administered. We review the pathogenesis of septic SOVT and briefly discuss the role of anticoagulants and steroids in this setting.
Ghosheh
Faris R
FR
University of Maryland, Department of Ophthalmology, Baltimore, Maryland 21201, USA.
Kathuria
Sajeev S
SS
D000792:Angiography; D002481:Cellulitis / Q000139:chemically induced* / Q000175:diagnosis; D005123:Eye / Q000098:blood supply*; D003932:Heroin / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007267:Injections; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage / Q000009:adverse effects*; D009915:Orbit; D009916:Orbital Diseases / Q000139:chemically induced* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed; D020246:Venous Thrombosis / Q000139:chemically induced* / Q000175:diagnosis; D014792:Visual Acuity
D009294:Narcotics; D003932:Heroin