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A 13-Year-Old Male With Left Eye Swelling.

Matthew A Nazari1,2, Jared S Rosenblum3, Zhengping Zhuang3,4

  • 1Department of Internal Medicine and Pediatrics, Georgetown University Hospital, Washington, District of Columbia.

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A pediatric case of orbital swelling and pain was investigated. Diagnostic endoscopic biopsy led to a definitive diagnosis and management plan.

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Area of Science:

  • Ophthalmology
  • Pediatrics
  • Otorhinolaryngology

Background:

  • Orbital and periorbital swelling in children can indicate various conditions.
  • Prompt diagnosis and management are crucial for preserving vision and function.

Observation:

  • A 13-year-old male presented with acute left eye swelling, erythema, and pain, particularly with upward and medial gaze.
  • Ocular examination, including globe, fundus, and visual fields, was normal.
  • Laboratory results showed a normal white blood cell count and erythrocyte sedimentation rate.

Findings:

  • Diagnostic endoscopic biopsy was performed to determine the cause of the supraorbital swelling.
  • The case discussion includes clinical reasoning, expert input, and diagnostic evaluation.
  • Relevant diagnostic algorithms are presented based on literature review and clinical experience.

Implications:

  • This case highlights the importance of a systematic approach to diagnosing orbital inflammatory conditions in pediatric patients.
  • Understanding the diagnostic pathway and management strategies is essential for ophthalmologists and pediatricians.
  • The presented algorithms can aid clinicians in evaluating similar presentations efficiently.