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Mechanisms of Visual Loss from Orbital Cellulitis

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Orbital Cellulitis and Periorbital Infections

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Abstract

Visual loss is an uncommon, though devastating, outcome of orbital cellulitis. Despite its severity, however, the mechanisms which cause visual loss are not well known. Most evidence comes from case reports and speculation. In this chapter, we provide a framework for understanding possible etiologies for visual loss in patients with orbital cellulitis. The mechanisms can be organized by a two-way categorization: location/structure affected in the visual pathway on one axis and disease processes on the other. Locations that may be affected include the anterior segment, retina, choroid, optic nerve, optic chiasm/tract, and cerebral cortex. Infectious processes may induce compressive effects, infiltration, inflammation, and vasculitis or thrombosis. For example, increasing orbital pressure secondary to orbital abscess formation may lead to visual loss from direct compression of the optic nerve, decreased optic nerve perfusion secondary to compression of its vasculature, or stretching of the optic nerve due to proptosis. Understanding such mechanisms can aid in further assessment and treatment of patients who present with visual loss in the setting of orbital cellulitis.

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Abbreviations

CRAO:

Central retinal artery occlusion

CRVO:

Central retinal vein occlusion

CST

Cavernous sinus thrombosis

HIV

Human immunodeficiency virus

IOP

Intraocular pressure

MRI

Magnetic resonance imaging

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Author information

Authors and Affiliations

  1. Baylor College of Medicine, 1977 Butler Blvd, Houston, TX, 77030, USA

    Paul D. Chamberlain BS

  2. Cullen Eye Institute, Baylor College of Medicine, 1977 Butler Blvd, Houston, TX, 77030, USA

    Rod Foroozan MD

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  1. Paul D. Chamberlain BS
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  2. Rod Foroozan MD
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Correspondence to Rod Foroozan MD .

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Editors and Affiliations

  1. Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA

    Michael T. Yen

  2. Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA

    Thomas E. Johnson

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Chamberlain, P.D., Foroozan, R. (2018). Mechanisms of Visual Loss from Orbital Cellulitis. In: Yen, M., Johnson, T. (eds) Orbital Cellulitis and Periorbital Infections. Springer, Cham. https://doi.org/10.1007/978-3-319-62606-2_3

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  • DOI: https://doi.org/10.1007/978-3-319-62606-2_3

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  • Publisher Name: Springer, Cham

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