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Retrobulbar abscess in a child
M I Hossain1, L Nahar, A K Talukder
1Dr Md Ismail Hossain, Assistant Professor, Department of Ophthalmology, Mymensingh Medical College, Mymensingh, Bangladesh.
Insights
A pediatric retrobulbar abscess caused severe eye proptosis and vision loss. Surgical drainage rapidly resolved symptoms, restoring ocular function and preventing long-term complications in this case.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Infectious Diseases
Background:
- Orbital infections can lead to severe ocular complications in children.
- Retrobulbar abscesses are rare but critical conditions requiring prompt diagnosis and management.
- Early intervention is crucial to prevent vision loss and systemic spread.
Observation:
- A 14-month-old male presented with fever, right eye redness, swelling, watering, and severe proptosis.
- Clinical examination revealed restricted ocular movement, conjunctival chemosis, and exposure keratitis.
- CT scan confirmed a retrobulbar abscess in the right orbit.
Findings:
- Surgical drainage of the retrobulbar abscess via a wide-bore needle was performed.
- Within 48 hours post-surgery, the patient showed improvement in extraocular motility and pupillary reaction.
- Fever and toxic signs resolved, and proptosis significantly reduced by discharge.
Implications:
- Prompt surgical intervention for pediatric retrobulbar abscesses can lead to rapid recovery.
- Effective management can prevent permanent visual impairment and orbital complications.
- This case highlights the importance of timely diagnosis and treatment in pediatric orbital emergencies.
Abstract:
A 14 months old male child was admitted into Mymensingh Medical College Hospital (MMCH), Bangladesh, with fever, watering, swelling, redness of right eye and running nose. On initial examination, patient was febrile, toxic, right-sided severe proptosis, restricted ocular movement, conjunctival chemosis and exposure keratitis of right eye. A sluggish pupillary light reaction was present in the right eye. Visual acuity was not recordable. CT scan of Brain and Orbit revealed, retrobulbar abscess of right orbit. The left eye was normal. The abscess was drained through a wide bore needle. The extraocular motility improved and pupil became brisk with a reduction in the temperature and toxic signs within 48 hours following surgery. Proptosis at the time of discharge from the hospital was absent in the right eye with no other complication. Post operative 8 months follow up period was excellent.
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