Mauriello J A, Wasserman B A
Department of Ophthalmology, UMDNJ-New Jersey Medical School, Newark 07103-2499, USA.
Ophthalmic Plast Reconstr Surg. 1996 Dec;12(4):294-5.
An 84-year-old woman developed a markedly proptotic right eye with external ophthalmoplegia and displacement of the globe into the superotemporal orbit. She had minimal pain and no history of the usual predisposing causes of orbital cellulitis. Vision was unaffected. Orbital computed tomography (CT) showed an extraconal inferomedial abscess with an adjacent intraconal component. A purulent abscess in the anterior inferomedial aspect of the orbit, which extended into the medial aspect of the intraconal space, was incised and drained. After surgery, the orbital inflammation and proptosis resolved, but an irreducible, nonpurulent lacrimal sac mucocele persisted. A dacryocystectomy was performed. Pathologic examination of the lacrimal sac biopsy specimen showed only chronic nongranulomatous inflammation. This case demonstrates that acute dacryocystitis may cause an intraconal orbital abscess with proptosis and complete external ophthalmoplegia, and represent a sight- and life-threatening condition.
一名84岁女性出现右眼明显突出，伴有眼球外肌麻痹，眼球移位至颞上眶。她仅有轻微疼痛，无眼眶蜂窝织炎常见的诱发因素病史。视力未受影响。眼眶计算机断层扫描（CT）显示眶锥外下内侧脓肿并伴有相邻的眶锥内成分。眼眶前下内侧的脓性脓肿延伸至眶锥内间隙，予以切开引流。术后，眼眶炎症和眼球突出症状缓解，但遗留不可复位的非脓性泪囊黏液囊肿。遂行泪囊摘除术。泪囊活检标本的病理检查仅显示慢性非肉芽肿性炎症。该病例表明，急性泪囊炎可导致眶锥内眼眶脓肿，伴有眼球突出和完全性眼球外肌麻痹，是一种威胁视力和生命的疾病。
