A rapidly enlarging swelling of the left orbit

R. S. Varughese, E. Ridgeon, A. Mathew, D. S.-D. Valle
2015 The BMJ (British Medical Journal)  
A rapidly enlarging swelling of the left orbit Rachel S Varughese foundation doctor 1 , Elliott Ridgeon foundation doctor 1 , Anna Mathew consultant paediatrician 2 , David Sola-Del Valle senior ophthalmology resident 3 A previously well 16 year old girl presented to acute medical admissions (walk-in assessment clinic) with a one week history of swelling of her left eyelid. She was prescribed amoxicillin for a presumed folliculitis. She re-presented one week later to the emergency department
more » ... ause the swelling had steadily worsened over the past two weeks. It was tender to palpation but there was no pain with movement. Visual acuity was reduced in the left eye to 6/9 (previously 6/6), and although the swelling appeared to push her left eye "down and to the side" she denied diplopia. Pupils were equal and reactive, and the conjunctiva on the left was mildly injected superonasally. Her eye movements were normal. She had no history of trauma, insect bites, fever, or fatigue. Blood test results were unremarkable.
doi:10.1136/bmj.h799 pmid:25716818 fatcat:cywgwbnz45d5bguhochnys7kgy