Blinding orbital cellulitis: a complication of strabismus surgery.
A 56-year-old healthy man underwent left medial rectus recession and lateral rectus resection for esotropia. The next day he developed severe left periocular pain with decreased vision, an afferent pupillary defect, periorbital edema, limited ocular motility, and proptosis. Computed tomography showed fat stranding and less than 90 degrees of posterior globe tenting. Despite intravenous antibiotics to treat orbital cellulitis, and a lateral canthotomy and cantholysis to decompress the orbit, visual acuity worsened to no light perception. The patient underwent emergent orbital decompression including release of the superior and inferior septum and outfracturing of the orbital floor and medial wall; however, there was no recovery of vision. Blinding orbital cellulitis is a rare complication after strabismus surgery. Despite poor prognosis, prompt diagnosis and aggressive treatment may maximize visual potential.
Hoyama
Erika
E
Oculoplastic Division, Londrina Eye Hospital, Londrina-PR, Brazil.
Limawararut
Vanessa
V
Leibovitch
Igal
I
Pater
John
J
Davis
Garry
G
Selva
Dinesh
D
D001766:Blindness / Q000000981:diagnostic imaging / Q000209:etiology*; D002481:Cellulitis / Q000150:complications* / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects*; D009916:Orbital Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D011183:Postoperative Complications; D013285:Strabismus / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014792:Visual Acuity