Alam Md Shahid, Paul Pragati, Sharma Survee, Desai Janhavi
Department of Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Aditya Birla Sankara Nethralaya (A Unit of Medical Research Foundation, Chennai), Kolkata, West Bengal, India.
Oman J Ophthalmol. 2025 Feb 25;18(1):55-57. doi: 10.4103/ojo.ojo_149_24. eCollection 2025 Jan-Apr.
A 59-year-old diabetic woman presented with acute dacryocystitis in her left eye and visual acuity of finger counting at two feet and was initially treated with topical and systemic antibiotics. However, her condition deteriorated, leading to left orbital cellulitis and a significant reduction in vision, with no perception of light. Prompt drainage of the lacrimal abscess was performed, and she was administered parenteral antibiotics. The patient showed clinical improvement and subsequently underwent external dacryocystorhinostomy after the acute infection had subsided. Unfortunately, her visual acuity did not improve significantly, with only a positive perception of light. Magnetic resonance imaging during the acute phase revealed optic nerve enhancement and focal signal changes, which persisted even after the infection had resolved. Acute dacryocystitis rarely advances to orbital cellulitis, which can result in vision loss, with only a few documented cases in literature. It is crucial to closely monitor such patients and promptly intervene with imaging and parenteral antibiotics, along with abscess drainage if indicated.
一名59岁的糖尿病女性因左眼急性泪囊炎就诊，视力为两米指数，最初接受了局部和全身抗生素治疗。然而，她的病情恶化，导致左眼眶蜂窝织炎，视力显著下降，无光感。及时进行了泪囊脓肿引流，并给予了静脉抗生素治疗。患者临床症状改善，急性感染消退后随后接受了外路泪囊鼻腔吻合术。不幸的是，她的视力没有明显改善，仅有光感。急性期的磁共振成像显示视神经强化和局灶性信号改变，即使感染消退后仍持续存在。急性泪囊炎很少发展为眼眶蜂窝织炎，眼眶蜂窝织炎可导致视力丧失，文献中仅有少数病例记载。密切监测此类患者并及时进行影像学检查和静脉使用抗生素干预，如有指征则进行脓肿引流至关重要。
