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Abstract

A 53-year-old woman was referred to our centre by a private aesthetic clinic. She presented with bilateral severe periorbital swelling and reduced visual acuity in her left eye for three days prior to presentation. She had undergone CO2 laser blepharoplasty one week prior to assessment. Ophthalmic examination revealed periorbital swelling in both eyes with pouring pus discharge from the lower lid as well as underlying erythematous and ulcerative skin. There was limitation of extraocular muscle movement and conjunctival chemosis. Right-eye vision was 6/9, left-eye vision was counting fingers secondary to anterior segment inflammation. No sign of optic nerve involvement was noted. Computed tomography findings showed rim-enhancing preseptal collections with air pockets bilaterally involving the lower eyelids and measuring 2.6 x 4.3 x 2.7 cm on the left and 2.3 x 4.2 x 2.8 cm on the right with an extension of the collection into the lateral extra-conal region. She was treated as bilateral orbital cellulitis secondary to postsurgical infection. The patient underwent incision and drainage and started with systemic antibiotics promptly. She showed significant improvement after treatment. This is an unusual complication from cosmetic surgery in which delayed treatment can lead to sight- and life-threatening complications.