Postoperative orbital swelling – Causes, diagnosis and management

SummaryObjectiveTo report the clinical features, aetiology, management practices of orbital swelling following eye surgery.MethodsA systematic recent search of subject headings and combinations such as orbital swelling, orbital cellulitis, periorbital swelling, preseptal cellulitis, postoperative orbital swelling and postoperative orbital cellulitis associated with eye surgery was performed in Medline, EMBASE, and the Cochrane database.ResultsThere were several case reports of orbital swelling following surgery and some were acute whilst others were slightly delayed. The majority of swellings were diagnosed as infective in most instances without evidence but the commonest cause was allergic reaction to hyaluronidase. The exact cause was unknown in many cases.ConclusionsAfter reviewing the literature, allergic reaction to hyaluronidase is the commonest cause of orbital swelling. Although infective orbital swelling is very rare, once diagnosed, it should be treated with appropriate antibiotics. A delay in diagnosis and treatment may result in loss of sight and life-threatening complications.