title: [Proptosis and ophthalmoplegia after cataract surgery].
abstract: We report a case of a 57 years old female presenting with proptosis, periorbital swelling and ophthalmoplegia, 4 days after an uneventful phacoemucification surgery. Visual acuity was 20/200, biomicroscopy showed mild corneal edema and anterior chamber cells with normal posterior segment. The patient was febrile with leukocytosis and elevated Levels of C-reactive protein. A head computed tomography venography scan showed left eye proptosis, bilateral paranasal sinus hyper-density with massive sinus vein thrombosis extending from the left ophthalmic vein to the left cavernous, transversal and sigmoidal sinuses, the right cavernous and sigmoidal sinuses and internal jugular veins bilaterally. Very mild infiltration was seen around the Left ophthalmic vein, with no other signs of orbital inflammation. Emergency endoscopic sinus surgery was performed followed by anticoagulation and antibiotic treatment, blood and sinus culture later grew streptococci. The therapeutic measures resulted in complete resolution of the ocular and systemic findings.
authors.affiliation: Department of Ophthalmology, Tel Aviv Medical Center, Tel Aviv Israel. ahaharyo@yahoo.com
authors.forename: Jonathan
authors.initials: J
authors.lastname: Shahar
authors.forename: Igal
authors.initials: I
authors.lastname: Leibovitch
authors.forename: Sharon
authors.initials: S
authors.lastname: Amit
authors.forename: Jennifer
authors.initials: J
authors.lastname: Zitser
authors.forename: Meira
authors.initials: M
authors.lastname: Neuderfer
authors.forename: Roee
authors.initials: R
authors.lastname: Landsberg
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000378:metabolism; D003131:Combined Modality Therapy; D004724:Endoscopy; D005094:Exophthalmos / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D007964:Leukocytosis / Q000209:etiology; D008875:Middle Aged; D009886:Ophthalmoplegia / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D018918:Phacoemulsification / Q000379:methods*; D014057:Tomography, X-Ray Computed; D014792:Visual Acuity
chemical_list: D000900:Anti-Bacterial Agents; D000925:Anticoagulants; D002097:C-Reactive Protein