Chandler et al described 5 groups of inflammatory or infectious complications associated with acute bacterial sinusitis. This is a modification of the scheme proposed by Smith and Spencer. The same pattern of reaction may be seen in other inflammatory processes involving the peri-orbital soft tissue.
Group |
Descriptor |
Features |
I |
inflammatory edema |
fluid drainage impeded; marked edema of the eyelids with or without edema of the orbital contents; no tenderness is present |
II |
orbital cellulitis |
diffuse edema, inflammation and bacteria without abscess formation |
III |
subperiosteal abscess |
|
IV |
orbital abscess |
usually exophthalmos |
V |
cavernous sinus thrombosis |
symptoms may appear in the opposite eye; prostration, meningismus and meningitis may be present |
Group |
Ocular Mobility |
Visual Acuity |
I |
no limitation in ocular mobility |
no impairment of visual acuity |
II |
|
variable impairment of visual acuity |
III |
no interference with ocular mobility during the early stages |
|
IV |
complete ophthalmoplegia present |
usually severe visual impairment present |
V |
complete ophthalmoplegia present |
usually severe visual impairment present |
Other complications:
(1) intracranial abscess (extra-dural, intra-cerebral)
(2) bacterial meningitis
(3) osteomyelitis
Specialty: Ophthalmology, Infectious Diseases, Immunology/Rheumatology