Orbital Cellulitis after Strabismus Surgery

Purpose: To report a case of preseptal cellulitis after strabismus surgery in a patient with no previous history of ocular surgery. Case summary: A 33-year-old male visited the ophthalmology clinic with a 4-day history of left eye pain and lid swelling after strabismus surgery. He was a healthy patient with a history of polio resulting in left hemiparalysis and difficulty walking. He was followed up with left medial rectus and lateral rectus muscle resection surgery for secondary sensory esotropia. His best corrected visual acuity was 0.6 in his left eye and physical examination revealed pain, eyelid edema, chemosis, and purulent discharge from the left conjunctival fornix. Computed tomography scanning with contrast enhancement revealed diffuse preseptal periorbital soft tissue swelling and enhanced fat stranding suggesting left preseptal cellulitis. The patient was hospitalized with intravenous broad spectrum antibiotics. Left eye swelling was improved and purulent discharge had decreased after 3 days; he was discharged after a 5-day course of intravenous antibiotic treatment. Oral antibiotics were administrated for 1 week. The patient had no recurrent symptoms during the 3-month follow-up. Conclusions: Although rare, preseptal cellulitis after strabismus surgery must be promptly recognized to prevent secondary complications related to infection.