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Periorbital and Orbital Infections

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Presentation on theme: "Periorbital and Orbital Infections"— Presentation transcript:

1 Periorbital and Orbital Infections
Morning Report 7/10/09

2 Swollen Eye Differential Diagnosis Noninfectious Causes
Periorbital (Preseptal) Orbital

3 Noninfectious Causes Blunt Trauma-increased swelling x48hrs then resolves over several days Tumor-gradual onset of proptosis in the absence of inflammation Hemangiomas of the lid Ocular tumors-retinoblastoma, choroidal melanoma Orbital neoplasms-neuroblastoma, rhabdomyosarcoma

4 Noninfectious Causes Cont.
Local edema-hypoproteinemia and congestive heart failure Bilateral Boggy Nontender Nondiscolored Allergic inflammation Contact hypersensitivity Angioneurotic edema

5 Anatomy

6 Anatomy

7 “Preseptal Cellulitis”
Local infections Conjunctivitis Hordeolum Chalazion Dacryoadenitis Dacryocystitis Bacterial Cellulitis (trauma) Hematogenous dissemination Bacterial periorbital cellulitis Acute Sinusitis-inflammatory edema

8 “Orbital Cellulitis” Acute Sinusitis Hematogenous dissemination
Subperiosteal Abscess Orbital Abscess Orbital Cellulitis Cavernous Sinus Thrombosis Hematogenous dissemination Traumatic inoculation

9 Symptoms Eye Pain with movement or Restricted eye movement
Painful swelling of upper and lower lids Proptosis Decreased Visual Acuity Fever Ill appearing

10 History Recent sinusitis or upper respiratory tract infection
Fever or malaise Recent facial trauma or surgery, dental work Infection elsewhere in the body

11 Physical Exam Proptosis Ophthalmoplegia Conjunctival chemosis
Decreased vision Elevated intraocular pressure Pain on eye movement Orbital pain and tenderness are present early. Dark red discoloration of the eyelids, chemosis, hyperemia of the conjunctiva Purulent nasal discharge may be present.

12 Lab Work CBC Blood Culture

13 Cat Scan


15 Management IV Antibiotics to cover S aureus, S pyogenes, S pneuomniae, H influenza, M catarrhalis Cephalosporins Unasyn +/- Clindamycin, Flagyl Surgical Drainage Optho ENT

16 Thank You

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