ABSTRACT
Background:
Orbital cellulitis is defined as acute inflammatory orbital swelling of infectious origin. Most often
secondary to
sinusitis. Intraocular
foreign bodies neglected because of their small size, or sometimes
radio-transparent
nature, can be difficult to
diagnose even with
radiology and be responsible for
orbital cellulitis. We demonstrate the diagnostic and
therapeutic difficulties.
Patients and
Methods:
This is a retrospective descriptive study of
patients with unilateral
orbital cellulitis revealing neglected intraocular
foreign bodies, conducted in the Department of
Adult Ophthalmology,
Hospital August 20, 1953, involving 58
patients, from January 2015 until December 2020.
Results:
The average age of the
patients was 38.5 years. The most affected
age group was between 21 and 30 years with a clear
male predominance. A decrease in
visual acuity was found in all
patients (
unilateral blindness 43%) and a
cellulitis complicated by a purulent melt (43%). All
patients received medical
treatment, including
intravitreal injections of
antibiotics in 71% of cases, and surgical
treatment consisting of extraction of the
foreign body and immediate evisceration of the eyeball in 25% of cases.
Conclusion:
Orbital cellulitis, although mostly
secondary to
sinusitis, can reveal various etiologies such as intra-orbital
foreign bodies that can go unnoticed and be
life-threatening and functionally damaging, especially when the
diagnosis is made late and management is inappropriate. The presence of an intraocular
foreign body must be suspected in all cases of orbital
trauma associated with a palpebral
wound, even if it is minimal, or in the presence of a clinical
aggravation. Any delay in
diagnosis and/or
treatment can
lead to serious
complications that can
affect the functional and even vital
prognosis. The surgical
treatment consists of the extraction of the
foreign body. The recourse to evisceration in our context unfortunately continues to persist at high rates; because of the delay of
consultation and thus of the management.