Ulcerated conjunctival mass as an initial presentation of idiopathic orbital inflammatory disease: a case report

Authors

  • Ivan Hong Wan Lau Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China https://orcid.org/0000-0003-3754-7432
  • Tracy Yuen Ting Kwok Department of Ophthalmology, Hong Kong Eye Hospital, Hong Kong SAR; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
  • Hunter Kwok Lai Yuen Department of Ophthalmology, Hong Kong Eye Hospital, Hong Kong SAR; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China

Keywords:

Administration and dosage, Conjunctival disease, Diagnostic imaging, Drug therapy, Glucocorticoids, Orbital pseudotumor

Abstract

A 62-year-old Chinese woman, with a history of immunoglobulin A nephropathy, presented with an ulcerative conjunctival lesion and anterior orbital inflammation. No infective foci were found, and her symptoms were not alleviated by antibiotic treatment or drainage of the lesion. She was diagnosed with idiopathic orbital inflammatory disease, also known as orbital pseudotumor, which completely resolved with oral corticosteroid treatment. To the best of our knowledge, this is the first documented case of idiopathic orbital inflammatory disease that initially presented with an ulcerative conjunctival lesion. We illustrate our stepwise diagnostic approach and management of the disease.

References

Rachwani-Anil R, Zamorano-Martín F, Rocha-de-Lossada C, et al. Orbital inflammatory disease. Arch Sociedad Española Oftalmol 2022;97:89-99.

Jacobs D, Galetta S. Diagnosis and management of orbital pseudotumor. Curr Opin Ophthalmol 2002;13:347-51.

Rootman J, Nugent R. The classification and management of acute orbital pseudotumors. Ophthalmology 1982;89:1040-8.

Swamy BN, McCluskey P, Nemet A, et al. Idiopathic orbital inflammatory syndrome: clinical features and treatment outcomes. Br J Ophthalmol 2007;91:1667-70.

Yuen SJA, Rubin PAD. Idiopathic orbital inflammation: ocular mechanisms and clinicopathology. Ophthalmol Clin North Am 2002;15:121-6.

Bijlsma WR. Progress in etiology, diagnosis, and therapy of idiopathic orbital inflammatory disease: Utrecht University; 2011.

Kaliki S, Freitag SK, Chodosh J. Nodulo-ulcerative ocular surface squamous neoplasia in 6 patients: a rare presentation. Cornea 2017;36:322-6.

Zamir E, Bodaghi B, Tugal-Tutkun I, et al. Conjunctival ulcers in Behçet's disease. Ophthalmology 2003;110:1137-41.

Hegab SM, al-Mutawa SA. Conjunctival ulcer in a patient with Crohn's disease. Ophthalmic Surg 1994;25:638-9.

Jain AK, Sukhija J, Chopra I, Sachdev N. Primary conjunctival herpetic geographic ulcer in an immunocompetent patient. Ann Ophthalmol (Skokie) 2007;39:67-9.

Rajasekaran A, Julian BA, Rizk DV. IgA nephropathy: an interesting autoimmune kidney disease. Am J Med Sci 2021;361:176-94.

Peeters V, De Raeve L. Blistering eruptions in Henoch-Schönlein syndrome: more common than assumed. Eur J Pediatr 2018;177:475-6.

Leone CR, Lloyd WC. Treatment protocol for orbital inflammatory disease. Ophthalmology 1985;92:1325-31.

Mombaerts I, Rose GE, Garrity JA. Orbital inflammation: biopsy first. Surv Ophthalmol 2016;61:664-9.

Downloads

Published

2024-01-02

How to Cite

1.
Lau IHW, Kwok TYT, Yuen HKL. Ulcerated conjunctival mass as an initial presentation of idiopathic orbital inflammatory disease: a case report. Hong Kong J Ophthalmol [Internet]. 2024Jan.2 [cited 2024Dec.5];27(2). Available from: https://hkjo.hk/index.php/hkjo/article/view/368

Issue

Vol. 27 No. 2 (2023)

Section

Case Report

License

Copyright (c) 2023 Hong Kong Journal of Ophthalmology

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

The Journal has a fully Open Access policy and publishes all articles under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence. For any use other than that permitted by this license, written permission must be obtained from the Journal.