Abstract Listings 2024

Purpose

To present a case of idiopathic systemic leaky capillary syndrome with late stage unilateral involvement of the orbit, ocular adnexa and globe.

Methods

A 64-year-old white male was referred for ophthalmic input after a three week history of neck pain, unexplained fever non-responsive to antibiotics, and the development of bilateral upper and lower limb oedema. The leg oedema was so severe that he required a wheelchair for mobility. Multiple other organ systems were involved, He was investigated for infective, neoplastic, rheumatological and haematologic disorders without identifying a specific cause. An ophthalmic consult was sought, and he underwent a full ophthalmic examination, and subsequent treatment for massive prolapsing conjunctival chemosis which was preventing lid closure.

Results

Examination revealed left choroidal effusions with raised intraocular pressure. Despite very restricted left globe movement there was little sign of posterior orbital involvement or extraocular muscle enlargement on imaging. His ocular management was IV methylprednisone and timolol 0.5% eye drops, and topical Maxidex with rapid resolution of his ophthalmic signs. Over the following two months, there has been no flare up of the condition on weaning steroid therapy.

Conclusion

This case demonstrated a sub-acute progressive course starting in the jaws and then sequentially involving the arms, the face, the legs, and then the eyelids and globe.

Additional Authors

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