Acute Infections of the Orbit

Abstract

Acute infections of the orbit now receive little attention in the literature, especially when compared with that given to orbital tumours. Yet they are common, potentially threatening not only to sight but also to life and are sometimes treated inadequately. In the pre-antibiotic era they were rightly regarded with considerable gravity. Birch-Hirschfeld’s large series from the beginning of this century had a mortality of 19%, and of the patients described in Ehler’s classical paper (1937), 5 of 35 died. In all series, of the patients who survived, Duke-Elder (1974) states that ‘some 20% were left with blindness of the affected eye and a further 13% remained with a grave impairment of vision’. Antibiotics have transformed the situation though it is interesting to note that of the first 5 patients ever to receive penicillin, 2 died and both had orbital infections; the first had severe septicaemia when treatment was started, and the second, a young boy, died of a ruptured mycotic aneurysm.