English

Abstract

INTRODUCTION: Orbit is a sterile closed compartment surrounded by bony walls on all sides and anteriorly by orbital septum. The orbit houses the eyeball and has the major function of protection of eyeball and helps in its motility in extreme degrees. Orbit has many potential spaces that make it a primary site of infections. It may present either as a secondary site for infections from the adjacent structures or intermediary site for infection to other vital sites. Orbital anatomy and its relation with other adjacent structures are important in the pathogenesis of orbital infections. These relationships also explain its devastating consequences and influence therapeutic decisions. Orbital and periorbital infections may be caused by variety bacterial, fungal and parasitic agents. Appropriate management depends on appreciation of topography of the process within the orbit and periorbital tissues using Radioimaging and identification of responsible organisms and its sensitivity to antibiotics using Microbiological study. Appropriate management by either medical or surgical treatment helps in prevention of complications.1e Integration of history, physical and ocular examination and ancillary testing allow achievement of these primary goals. AIM OF THE STUDY: To evaluate orbital infections and analyse the role of Radioimaging and Microbiological study in early diagnosis, management and outcome. OBJECTIVES: To analyse the prevalence, etiopathogenesis and various clinical presentations of orbital infections and role of Radioimaging and Microbiological study in its early diagnosis, treatment and outcome. METHODS OF EVALUATION: This prospective study was conducted at Orbit and Oculoplasty department, RIOGOH, Egmore, Chennai for a period of 12 months during when 30 patients with Orbital infections were evaluated RESULTS: Out of 30 patients, 16 patients (53.4%) were diagnosed to have Preseptal cellulitis, 8 patients (26.7%) and 4 patients (13.3%) were diagnosed with Orbital cellulitis and Orbital abscess respectively. Rest of the 2 patients were diagnosed with Subperiosteal abscess and Cavernous sinus thrombosis. Radiological and Microbiological investigations were done in patients according to their needs Out of the 20 medically treated with appropriate antibiotics, all patients improved. Out of the 10 surgically treated, 2 patients (20%) deteriorated. CONCLUSION: Orbital infections are more common in paediatric age group and preseptal cellulitis is the commonest infection encountered. Periocular infections are the most common causative factor for the orbital infections. Bacteria is the major causative organism for orbital infections. Among it, gram positive organisms predominate the cause. Fungi constituted the second major cause. Radioimaging like X Ray, B scan, CT Scan and MRI help in diagnosis, identification of complications and in assessment of response of treatment in orbital infections. They are complimentary to one another. Microbiological study with Gram Staining, Culture and Sensitivity and Fungal culture help in the identification of Strain of Organism and in Correct choice of antibiotics that is important in the complete cure of infections. Most of the orbital infections resolve with the prompt treatment. Surgical approach forms the treatment of choice in abscess and it should be followed by medical treatment according to the microbiological study. Radioimaging and Microbiological study play a significant role in the choice of treatment. Radioimaging is used to assess, response to treatment and to modify treatment for a better outcome.