Orbital cellulitis and intraconal abscess formation after strabismus surgery in an adult patient

• Published in: Journal of AAPOS Vol. 18; no. 1; pp. 82 - 84
• Main Authors: Strul, Sasha, MD, McCracken, Michael S., MD, Cunin, Kathryn, MD
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.02.2014
• Subjects: Abscess - diagnosis; Abscess - drug therapy; Abscess - microbiology; Anti-Bacterial Agents - therapeutic use; Ceftriaxone - therapeutic use; Clindamycin - therapeutic use; Drainage - methods; Drug Therapy, Combination; Eye Infections, Bacterial - diagnosis; Eye Infections, Bacterial - drug therapy; Eye Infections, Bacterial - microbiology; Female; Humans; Magnetic Resonance Imaging; Middle Aged; Oculomotor Muscles - surgery; Ophthalmologic Surgical Procedures - adverse effects; Ophthalmology; Orbital Cellulitis - diagnosis; Orbital Cellulitis - drug therapy; Orbital Cellulitis - microbiology; Strabismus - surgery; Streptococcal Infections - diagnosis; Streptococcal Infections - drug therapy; Streptococcal Infections - microbiology; Thienamycins - therapeutic use; Tomography, X-Ray Computed; Visual Acuity - physiology
• ISSN: 1091-8531; 1528-3933
• DOI: 10.1016/j.jaapos.2013.09.011

We report a 60-year-old woman who presented with orbital cellulitis, restricted ocular motility, proptosis, and visual acuity of counting fingers in her left eye 3 days after strabismus surgery. Although she initially responded well to antibiotic and anti-inflammatory therapy, visual acuity in the left eye again decreased on postoperative day 5. Radiographic imaging revealed an intraconal orbital abscess, and she underwent left lateral orbitotomy with abscess drainage, with continued antibiotics and a tapering dose of steroids. To our knowledge, this is the first case of orbital cellulitis and intraconal abscess after strabismus surgery in an adult.