Orbital cellulitis--an unusual presentation and late complication of severe facial trauma

We report an unusual case of orbital cellulitis in a patient with only one seeing eye and severe facial asymmetry secondary to a road traffic accident twenty two years previously. Facial trauma sustained in the road traffic accident created continuity between the right orbit and the adjacent ethmoidal cells. The abnormal communication between the ethmoidal labyrinth and the right orbit rendered this patient highly susceptible to an orbital cellulitis from an adjacent paranasal sinus infection. However, this case is unusual with regard to the length of time that elapsed before such an infection became manifest and the presence of gross distortion of anatomy masked the usual presentation and thereby caused a delay in diagnosis.