One and half month old baby was brought with progressive redness and swelling of left eye which started 2 days back. On examination child is active, playful. pupill could not be examined. Discuss management.

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Examine under deep sedation / EUA, to exclude keratitis bacterial and or Mixed fungal , to prevent blindness. D / D :- 1 ) FB 2 ) Orbital cellulitis with / without keratoconjunctivitis . 3 ) Insect bite, h/o acute onset will be there 4 ) Stye etc Urgent opinion of Ophthalmologist is suggested. Immediate Topical and systemic Antibiotics of choice. Swabs and if necessary corneal scrap for Gram's stain, KOH Preparation , bacterial and fungal culture will be helpful.

Without examination of eye ,definite pathology can't be said ; but from whatever is seen in the picture , severe acute conjunctivitis with preriorbital edema is a likely possibility As child is active & playful , orbital cellulitis is less likely . Insect bite is also a possibility .

DDs- orbital cellulitis Insect bite Style Blepharitis or conjunctivitis

This is definitely not Stye or blepharitis . ( Replied by dr h b Gajjar - ophthalmologist ).
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This is a case of LEFT ORBITAL CELLULITIS. OPTHOLOMOLOGICAL EVALUATION IS MANDITORY TO KNOW THE ETIOLOGY OF THE ORBITAL CELLULITIS. CULTURES OF THE EYE, & GRAM STAIN GIVES THE ETIOLOGICAL DX. RX : I.V. ANTIBIOTICS, & TOPICAL ANTIBIOTICS DROPS IMPROVES THE CONDITION.

Orbital cellulitis

It's not stye, blepharitis, or conjunctivitis as per definition of the following, can be orbital cellulitis or insect bite, history can b taken from guardians, systemic antibiotics has to started as the periorbital tissues are involved.

Dint c pic clearly, conjunctivitis also present, antihistamines also be given with topical tobramycin drops and ointments.
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Conjunctivitis with preseptal cellulitis Moxflox e/d Getifloxacin e/d augmentin syrup 8 hourly ibugesic syrup If required parental antibiotic with pediatritiab advise for dose

Looks to b orbital cellulitis,but needed ophthalmic opinion

the pic is not clear but preseptal cellulitis is there .It appears that Corneal involvement is also present .pls look for any anterior segment findings as well as posterior segment becoz retinoblastoma can also present as orbital cellulitis . go for bscan as well to confirm the diagnosis.

Orbital cellulitis

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