Related Experiment Video
Updated: Oct 17, 2025
Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
Published on: May 25, 2020
A Proposed Diagnostic Algorithm for Fungal Orbital Infections after 20 Years of Experience in a Tertiary Eye Care
Mohamed Ashraf Eldesouky1, Hazem A Elbedewy1
1Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt.
Method:
Medical Records of cases with orbital fungal infection from January 2000 to December 2019 were reviewed.
Results:
The study included 45 patients. Mucormycosis was proven in 32 (71.1%) and aspergillosis in 13 (28.9%) patients. Thirty-five (77.8%) patients had predisposing factors mainly uncontrolled diabetes. Twenty-seven (60%) patients presented with orbital apex syndrome, 10 (22.2%) with orbital cellulitis and 8 (17.7%) with proptosis. The prognosis was generally poor (31.1% mortality, 8.88% exenteration and 11.1% self-evisceration). The proposed algorithm composed of six atypical clinical presentations mainly acute orbital apex and fulminating orbital cellulitis plus any radiological or microbiological findings.
Conclusion:
The proposed algorithm markedly reduced the complications after 5 years of the study. Once fungal orbital infection is suspected, treatment should start immediately.
Insights
Orbital fungal infections, primarily mucormycosis and aspergillosis, present serious risks, especially in diabetic patients. An early detection algorithm significantly reduced complications, emphasizing prompt treatment for suspected cases.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Medical Mycology
Background:
- Orbital fungal infections pose a significant threat to vision and life.
- Predisposing factors, particularly uncontrolled diabetes, are common in affected individuals.
- Clinical presentations vary, including orbital apex syndrome, cellulitis, and proptosis.
Purpose of the Study:
- To review cases of orbital fungal infection.
- To identify clinical presentations and outcomes.
- To propose an early detection and management algorithm.
Main Methods:
- Retrospective review of medical records of patients with orbital fungal infections from January 2000 to December 2019.
- Analysis of patient demographics, predisposing factors, clinical presentations, and treatment outcomes.
- Development of a diagnostic and management algorithm based on clinical, radiological, and microbiological findings.
Main Results:
- The study included 45 patients with orbital fungal infections.
- Mucormycosis (71.1%) and aspergillosis (28.9%) were the most common fungal types.
- High rates of mortality (31.1%) and severe complications (exenteration, self-evisceration) were observed.
- Predisposing factors, mainly uncontrolled diabetes (77.8%), were prevalent.
- Orbital apex syndrome was the most frequent presentation (60%).
Conclusions:
- A proposed algorithm incorporating atypical presentations and diagnostic findings markedly reduced complications over five years.
- Immediate treatment initiation is crucial upon suspicion of fungal orbital infection.
- Early diagnosis and intervention are key to improving outcomes in orbital fungal infections.
