A 67-year-old Korean man, who had been diagnosed with EKC and treated for conjunctival injection and chemosis in the right eye for 4 days, was referred to Oculoplastics as
orbital cellulitis was suspected. At the point of referral, clinical features such as decreased visual acuity, severe eyelid swelling, chemosis, follicles,
corneal edema, limitations in lateral eye movement, and
diplopia were observed in the right eye.
Orbital cellulitis was suspected according to orbital computed tomography scan images, but there was no response to systemic
antibiotics. Systemic
steroid was administered instead, and then his symptoms and signs started to improve. The final diagnosis of this patient was orbital
inflammation related to EKC based on the facts that there was no response to
antibiotics, that he presented with contralateral symptoms and signs, that pseudomembrane formation occurred in both eyes, and that the symptoms resolved completely after 2 weeks.
CONCLUSION: Clinicians need to consider the possibility of orbital
inflammation developing from EKC, even in an adult patient, and treat the patient properly if the EKC symptoms and signs, such as conjunctival injection and follicles, are accompanied with symptoms and signs similar to
orbital cellulitis.