Related Experiment Video
Updated: Nov 30, 2025
Three-Dimensional Reconstruction of Orbital Fractures
Published on: May 16, 2025
Bilateral idiopathic orbital pseudotumour in a child: a case report
Fangyuan Chen1, Junjie Tang1, Qing Zhou2
1The Department of Ophthalmology, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue, Tianhe District of Guangzhou, Guangzhou, Guangdong Province, China.
Insights
Idiopathic orbital pseudotumour is rare in children. This case highlights its potential for acute orbital syndrome, emphasizing prompt diagnosis and treatment for vision preservation.
Area of Science:
- Ophthalmology
- Pediatric Medicine
Background:
- Idiopathic orbital pseudotumour (IOP) is an uncommon condition in pediatric patients.
- This report details a rare case of bilateral IOP in a child.
Observation:
- A 14-year-old female presented with symptoms mimicking a severe cold and cough, complicated by bilateral eyelid swelling.
- Ocular symptoms rapidly progressed to include pain, visual deterioration, elevated intraocular pressure, and nausea/vomiting.
- Orbital magnetic resonance imaging (MRI) confirmed the diagnosis after excluding infection and malignancy.
Findings:
- The patient exhibited signs of acute orbital syndrome: pain, proptosis, restricted eye movements, periorbital edema, chemosis, vision loss, and high intraocular pressure.
- Intravenous dexamethasone treatment led to favorable outcomes, reducing intraocular pressure and improving vision.
Implications:
- This case underscores the importance of considering idiopathic orbital pseudotumour in the differential diagnosis of acute orbital syndromes in children.
- Early recognition and management are crucial for preventing vision loss in pediatric patients with orbital inflammatory conditions.
Background:
Idiopathic orbital pseudotumour is rare in children. We report a case of bilateral paediatric idiopathic orbital pseudotumour and review the characteristics of this case.
Case Presentation:
A 14-year-old female patient presented at our Department of Pulmonary and Critical Care Medicine (PCCM) with complaints of recurrent severe cold and cough for 3 weeks, which had been treated with an intravenous antibiotic. Meanwhile, the patient developed swelling of both eyelids during the period of cold and cough, but her symptoms did not improve after the ocular administration of tobramycin dexamethasone eye drops. The patient was referred from the respiratory medicine ward to our department because of gradually worsening ocular pain, visual deterioration, increased intraocular pressure and serious nausea/vomiting within 24 h of hospitalization. The diagnosis of bilateral idiopathic orbital pseudotumour was made ultimately because of the course of the disease, exclusion of diagnoses such as bacterial ocular infection or malignant tumours and subsequent evidence from orbital magnetic resonance imaging (MRI). Favourable progress in the ocular tension and eyelid swelling was achieved through treatment with intravenous dexamethasone. The binocular intraocular pressure gradually declined to approximately 15 mmHg, and there was favourable progression in the patient's vision to 20/40 in both eyes on the ninth day of hospitalization.
Conclusions:
Our patient developed rapidly progressive acute orbital signs and symptoms and anterior inflammation, such as pain, proptosis, limited ductions, periorbital oedema, chemosis, vision loss and high intraocular pressure. This case highlights that idiopathic orbital pseudotumour is an uncommon but important cause of acute orbital syndrome in children.
