Orbital

Mucormycosis

Mucormycosis is a fungal infection caused by fungi/mold of the class Zygomycetes. Also known as black fungus, it is a rare and serious condition mostly impacting immunocompromised patients and those with diabetes. It can impact the orbital, nasal, cerebral, pulmonary, and gastrointestinal systems. It can cause ischemia and infarction of tissue along with vascular occlusion. Treatment may require orbital and sinus exenteration, coupled with both systemic and local treatment with antibiotics. Correction of the underlying metabolic abnormality and debridement of all involved infected tissue are important considerations. Hyperbaric oxygen therapy might be beneficial.

Orbital cellulitis

Orbital cellulitis is a bacterial infection involving the tissue behind the orbit that can lead to both vision loss and other complications if left untreated. It can be caused by the spread of infection from the sinuses or other nearby areas (face, lacrimal sac, and lacrimal gland which can extend into the orbit). Symptoms include redness, swelling, fever, proptosis, and pain on globe movement. The most common bacterial pathogens in preseptal cellulitis include Haemophilus influenza, Staphylococcus aureus, and Streptococcus pneumoni. Treatment involves oral antibiotics. If the infection progresses, a CT scan should be initiated to determine abscess conditions. Drainage and/or surgery may be considered. Note that rapid progression of proptosis and neurologic signs of intracranial dysfunction can lead to meningitis.