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A 73-year-old man with acute orbital swelling following cataract surgery
Digital Journal of Ophthalmology 2007
Volume 13, Number 8
August 28, 2007
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Conor Mulholland | The Royal Victoria Hospital, Belfast
Diagnosis and Discussion
This case report describes an unusual case of acute orbital swelling following cataract surgery caused by hypersensitivity to hyaluronidase, a component of the sub-Tenon’s local anesthetic mix. Hypersensitivity was confirmed on cutaneous patch testing.

The presentation in this case was similar to that described in a previous case series of hypersensitivity reactions to hyaluronidase following peribulbar anaesthetic for cataract surgery.(7) The typical presenting features in this case series were proptosis, peribulbar erythema and itching, restriction of extraocular muscle function, conjunctival chemosis, pain and itch. The management in this case involved observation and oral anti-histamines. Complete resolution occurred over the following 7 days.