Bilateral idiopathic orbital pseudotumour in a child: a case
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Idiopathic orbital pseudotumour is rare in children. A 14-year-old female patient presented with complaints of recurrent severe cold and cough for 3?weeks, which had been treated with an intravenous antibiotic. Meanwhile, the patient developed swelling of both eyelids during the period of cold and cough, but her symptoms did not improve after the ocular administration of tobramycin dexamethasone eye drops. The patient was referred from the respiratory medicine ward because of gradually worsening ocular pain, visual deterioration, increased intraocular pressure and serious nausea/vomiting within 24?h of hospitalization.

The diagnosis of bilateral idiopathic orbital pseudotumour was made ultimately because of the course of the disease, exclusion of diagnoses such as bacterial ocular infection or malignant tumors, and subsequent evidence from orbital magnetic resonance imaging (MRI). Favorable progress in the ocular tension and eyelid swelling was achieved through treatment with intravenous dexamethasone. The binocular intraocular pressure gradually declined to approximately 15?mmHg, and there was favorable progression in the patient’s vision to 20/40 in both eyes on the ninth day of hospitalization.

The patient developed rapidly progressive acute orbital signs and symptoms and anterior inflammation, such as pain, proptosis, limited ductions, periorbital edema, chemosis, vision loss, and high intraocular pressure. This case highlights that idiopathic orbital pseudotumour is an uncommon but important cause of acute orbital syndrome in children.