June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Pediatric Orbital Cellulitis Requiring Diverse Surgical Approaches
Author Affiliations & Notes
  • Preema Mehta Buch
    Ophthalmology, University of Pennsylvania/Scheie Eye Institute, Philadelphia, Pennsylvania, United States
    Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • William Katowitz
    Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
    Ophthalmology, University of Pennsylvania/Scheie Eye Institute, Philadelphia, Pennsylvania, United States
  • Karen Revere
    Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
    Ophthalmology, University of Pennsylvania/Scheie Eye Institute, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Preema Buch, None; William Katowitz, None; Karen Revere, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5148. doi:
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      Preema Mehta Buch, William Katowitz, Karen Revere; Pediatric Orbital Cellulitis Requiring Diverse Surgical Approaches. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5148.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Pediatric orbital cellulitis is an urgent medical condition which can result in blindness, as well as death. It is well known that sinus infections are the most common cause of orbital cellulitis; however, it is important to be aware of other complications and sites of infection which may need different management and treatment. This study reviews and analyzes a large number of pediatric orbital cellulitis cases requiring diverse surgical interventions.

Methods : This is a retrospective chart review of pediatric subjects with orbital cellulitis who failed IV antibiotic therapy and required surgical intervention at the Children’s Hospital of Philadelphia, between May 2009 – 2016. The source of infection, complications, medical and surgical treatments were analyzed.

Results : 32 subjects were identified, with a mean age of 9.04 years. 26/32 (81%) patients had sinusitis, which was the most common. 18/32 (56%) with an orbital roof abscess (average age of 11.58 years). 6/32 (19%) patients with a medial orbital abscess (average age 4.17 years). 7 (22%) patients were found to have intracranial infections.

Conclusions : This is a large review of pediatric orbital cellulitis cases refractory to IV antibiotics, requiring surgical intervention. Pediatric orbital cellulitis is vision threatening as well as life threatening and needs to be diagnosed and treated promptly. Surgical approaches differ based on the location of the abscess and may need a multidisciplinary team involved. Also, in this study the incidence of subdural empyema as a complication of sinusitis and orbital cellulitis is higher than previously reported.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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