Purpose

To report a unique case of orbital compartment syndrome (OCS) in a pediatric burn patient with confirmed Interleukin-10 (IL-10) deficiency and to explore a potential immunologic contribution to orbital pressure dysregulation.

---

Methods

A seven-year-old girl with familial IL-10 deficiency sustained extensive third-degree burns involving 70% of total body surface area, including the periorbital region. Oculoplastic evaluation was performed in the pediatric intensive care unit. Clinical findings, surgical management, and systemic course were documented. A focused review of IL-10’s role in inflammatory and orbital pathology was conducted to contextualize the case.

---

Results

Examination revealed severe bilateral periorbital edema, marked chemosis, resistance to retropulsion, elevated intraocular pressure (47 mmHg OD, 52 mmHg OS), optic disc edema, and restricted extraocular motility, consistent with acute OCS. Emergent bilateral lateral canthotomy and cantholysis reduced intraocular pressure to normal levels (19 mmHg OD, 18 mmHg OS). Temporary tarsorrhaphy was performed to prevent exposure keratopathy. Orbital signs resolved within 10 days, with normalization of intraocular pressure and motility.

Despite successful ocular intervention, the patient developed septicemia and multi-organ failure, leading to death on hospital day 16.

---

Conclusion

IL-10 plays a critical role in regulating pro-inflammatory cytokines and vascular permeability. In the anatomically confined orbital space, impaired anti-inflammatory signaling may potentiate edema and rapid pressure elevation. This case underscores the importance of early recognition and emergent decompression in critically ill burn patients, particularly those with underlying immune dysregulation.

---

Additional Authors

First name	Last name	Base Hospital / Institution
Oren	Iny	Assuta Samson Medical Center, Ashdod, Israel
Ahmad	Mansour	Soroka University Medical Center, Beersheba, Israel

↑ Back to top