Last Updated on December 31, 2018 by FRCEM Intermediate

Common organisms

• S-pneumoniae
• S-aureus
• S-pyogenes
• H-influenzae

Symptoms and signs

1. Proptosis
2. Ophthalmoplegia
3. Pain on eye movements
4. Decreased visual acuity
5. Ocular tenderness
6. More marked fever and systemic features

Investigations

• CT Orbit

Management

• Obtain venous access send bloods  for FBC, U/E, Lactate, take blood for cultures,
• Start an IV 0.9%, Saline
• Commence intravenous antibiotics
• Refer urgently to the ophthalmologist.

Complication

• Permanent visual loss
• Central retinal artery or vein occlusion
• Optic neuropathy
• Cavernous sinus thrombosis
• Brain abscess
• Meningitis