title: Orbital inflammation secondary to a delayed hypersensitivity reaction to sub-Tenon's hyaluronidase.
abstract: We report a rare case of a delayed orbital inflammation with raised intraocular pressure as a result of hyluronidase allergy following sub-Tenon's anaesthesia. Here, we have shown evidence to prove the orbital inflammation to be an allergic response to hyluronidase with a skin patch test. This is the first case to our knowledge of a delayed hypersensitivity reaction to sub-Tenon's hyluronidase comprising of an initial exposure to hyluronidase in the fellow eye with no subsequent allergic response, but with a subsequent delayed reaction to hyluronidase during a second eye cataract surgery. This case demonstrates hyaluronidase allergy should be considered as a differential diagnosis among patients presenting with acute post-operative orbital inflammation, even if there is a history of previous exposure to hyaluronidase in the fellow eye with no subsequent allergic response.
authors.affiliation: Tennent Institute of Ophthalmology, Gartnaval General Hospital , Glasgow , UK.
authors.forename: Soo
authors.initials: S
authors.lastname: Park
authors.forename: Lik Thai
authors.initials: LT
authors.lastname: Lim
mesh_terms: D000368:Aged; D000772:Anesthesia, Local; D002386:Cataract / Q000150:complications; D004342:Drug Hypersensitivity / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D006821:Hyaluronoglucosaminidase / Q000009:adverse effects*; D006968:Hypersensitivity, Delayed / Q000139:chemically induced* / Q000000981:diagnostic imaging; D007429:Intraocular Pressure / Q000187:drug effects; D019654:Lens Implantation, Intraocular; D009798:Ocular Hypertension / Q000139:chemically induced; D054517:Orbital Cellulitis / Q000139:chemically induced* / Q000000981:diagnostic imaging; D018918:Phacoemulsification; D012882:Skin Tests; D014057:Tomography, X-Ray Computed; D014792:Visual Acuity
chemical_list: D006821:Hyaluronoglucosaminidase