title: Orbital inflammation developing from epidemic keratoconjunctivitis in an adult.
abstract: BACKGROUND
  We report a rare case of epidemic keratoconjunctivitis (EKC) that developed into an orbital inflammation in an adult.
  
  
  METHODS
  A 67-year-old Korean man, who had been diagnosed with EKC and treated for conjunctival injection and chemosis in the right eye for 4 days, was referred to Oculoplastics as orbital cellulitis was suspected. At the point of referral, clinical features such as decreased visual acuity, severe eyelid swelling, chemosis, follicles, corneal edema, limitations in lateral eye movement, and diplopia were observed in the right eye. Orbital cellulitis was suspected according to orbital computed tomography scan images, but there was no response to systemic antibiotics. Systemic steroid was administered instead, and then his symptoms and signs started to improve. The final diagnosis of this patient was orbital inflammation related to EKC based on the facts that there was no response to antibiotics, that he presented with contralateral symptoms and signs, that pseudomembrane formation occurred in both eyes, and that the symptoms resolved completely after 2 weeks.
  
  
  CONCLUSIONS
  Clinicians need to consider the possibility of orbital inflammation developing from EKC, even in an adult patient, and treat the patient properly if the EKC symptoms and signs, such as conjunctival injection and follicles, are accompanied with symptoms and signs similar to orbital cellulitis.
authors.affiliation: Department of Ophthalmology, Saevit Eye Hospital, Goyang-si, Republic of Korea.
authors.forename: Sung In
authors.initials: SI
authors.lastname: Kim
authors.forename: Kyeong Wook
authors.initials: KW
authors.lastname: Lee
keywords: Epidemic keratoconjunctivitis; Idiopathic orbital inflammation; Orbital cellulitis; Orbital inflammation
references.citation: Eye (Lond). 1994;8 ( Pt 5):577-9
references.pmid: 7835456
references.citation: Curr Opin Ophthalmol. 1998 Oct;9(5):41-8
references.pmid: 10387481
references.citation: Ophthalmology. 2009 Mar;116(3):591-591.e1
references.pmid: 19264216
references.citation: Br J Ophthalmol. 2011 Aug;95(8):1043
references.pmid: 21670070
references.citation: Ophthalmic Plast Reconstr Surg. 2005 Sep;21(5):363-6; discussion 366-7
references.pmid: 16234700
references.citation: Ophthalmic Plast Reconstr Surg. 2012 Sep-Oct;28(5):e113-5
references.pmid: 22391741
references.citation: Acta Ophthalmol Scand. 1996 Apr;74(2):191-3
references.pmid: 8739689
references.citation: Pediatr Infect Dis J. 1996 Mar;15(3):266-7
references.pmid: 8852918
references.citation: AMA Arch Ophthalmol. 1959 Jun;61(6):891-8
references.pmid: 13649019
references.citation: Br Med J. 1978 Jul 1;2(6129):13-4
references.pmid: 678780
references.citation: J Pediatr Ophthalmol Strabismus. 1989 Sep-Oct;26(5):232-4; discussion 235
references.pmid: 2795411
references.citation: Ophthalmology. 2000 Feb;107(2):397-401
references.pmid: 10690844
references.citation: Eye (Lond). 2006 Oct;20(10):1196-206
references.pmid: 17019419
references.citation: Infect Dis Clin North Am. 1992 Dec;6(4):933-52
references.pmid: 1460272
references.citation: Epidemiol Infect. 2000 Oct;125(2):333-45
references.pmid: 11117957
references.citation: Int J Pediatr Otorhinolaryngol. 1999 Jun 15;49(1):81-6
references.pmid: 10428409