Malarvizhi Raman1, Sujatha Rajendran2, Pavithra P3
Orbital infections are caused by variety of bacterial, fungal and parasitic agents. Its appropriate management depends on appreciation of topography of the process within the orbit and periorbital tissues by radio imaging and identification of causative organisms and its sensitivity to antibiotics by microbiological study. Timely management by medical or surgical treatment prevents further complications.
MATERIALS AND METHODS
This is a prospective study for a period of 14 months from June 2015 to July 2016. 30 patients presented to Orbit and Oculoplasty Services, RIOGOH, Chennai, were registered, evaluated and followed up during the study period. A detailed history taking, complete general and ocular examination were done. Slit-lamp and fundus examination, field charting, IOP, Hertel’s exophthalmometry were measured. Systemic evaluation was performed. Complete haemogram, radiological investigations and microbiological study were done for appropriate patients. Patients were managed depending on the aetiology either by medical or by surgical intervention. Further response to treatment and the incidence of complications were assessed in the follow up period.
In this study, the most common age group presenting with orbital infections were from 1-10 years, followed by 31-40 years with male preponderance both in paediatric and adult age group. Laterality was to the left eye. Periocular infection was the most common aetiology. CT was done in 63%, B scan in 53% and x-ray in 50% of the patients. These radiological investigations helped in the early diagnosis and appropriate management. 37% of patients underwent microbiological study and depending on the aetiology, 67% underwent medical management and 33% surgical intervention. Common complications encountered were exposure keratitis, lid abscess and panophthalmitis.
Orbital infections were more common in paediatric age group and preseptal cellulitis was the commonest infection encountered. Radio imaging aids in diagnosis, identification of complications and in assessment of response to treatment of orbital infections. Microbiological study helped in the identification of strain of organism and in appropriate choice of antibiotics. Most of the orbital infections resolved with early diagnosis and prompt treatment and reduction in the incidence of complications.