J Korean Ophthalmol Soc > Volume 60(1); 2019 > Article
Journal of the Korean Ophthalmological Society 2019;60(1):69-74.
DOI: https://doi.org/10.3341/jkos.2019.60.1.69    Published online January 15, 2019.
A Case of Acute Dacryocystitis Diagnosed after Surgical Treatment of Orbital Cellulitis and Orbital Abscess.
Min Gu Huh, Jong Myung Yun, Mi Seon Kwak
Department of Ophthalmology, Daegu Fatima Hospital, Daegu, Korea. mskwak66@hotmail.com
안와연조직염 및 안와농양의 수술적 치료 후 진단된 급성눈물주머니염 1예
허민구⋅윤종명⋅곽미선
대구파티마병원 안과
Correspondence:  Mi Seon Kwak,
Email: mskwak66@hotmail.com
Received: 17 May 2018   • Revised: 28 June 2018   • Accepted: 23 December 2018
Abstract
PURPOSE
We report a case of acute dacryocystitis diagnosed with abscess and rupture of lacrimal sac and fistula to posterior orbit during the operation. CASE SUMMARY: A 71-year-old woman visited our clinic with edema and pain in the eyelid from three days ago. For past four months, there was viscous of the left eye and tears. The patient had severe conjunctival chemosis and hyperemia, compared with the left eyelid edema and redness. Orbital CT scan showed orbital cellulitis, which was followed by systemic antibiotics and steroid therapy. On the 4th day of therapy, orbital abscess formation was observed in orbit MRI and surgical drainage was planned. During surgery, we found rupture of the posterior part of lacrimal sac and fistula to posterior orbit. Pseudomonas aeruginosa was identified in the bacterial cultures, and after the administration of appropriate antibiotics, the disease showed improved progress, and then additional dacryocystorhinostomy was performed. CONCLUSIONS: In our case, acute dacryocystitis rarely spread in orbit, which may lead to delayed diagnosis, orbital cellulitis and abscess, resulting in serious complications of vision threat. So, we think that it is necessary to consider surgical treatment more actively in the stage of chronic dacryocysitis.
Key Words: Dacryocystitis;Orbital abscess;Orbital cellulitis


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