Orbital Abscess With Vision Threatening Optic Neuropathy Due to Odontogenic Sinusitis in Adolescence: A Case Report and Literature Review

Orbital abscesses secondary to odontogenic infections are rare but can lead to serious complications, including compressive optic neuropathy and permanent vision loss, if not diagnosed and treated promptly. We present the case of a 13-year-old child with a radiologically confirmed orbital abscess associated with a recent odontogenic infection. The patient initially presented with a one-week history of right eyelid swelling and fever. The symptoms began after treatment for dental caries, during which the patient was prescribed a three-day course of oral antibiotics. Despite emergency pulp extirpation, the swelling worsened, leading to severe proptosis, decreased vision, and mild optic nerve dysfunction. Surgical exploration of the right orbit with incision and drainage revealed 8 mL of thick purulent material. Culture results confirmed Streptococcus intermedius as the causative organism. Following a combination of intravenous antibiotics and surgical intervention, the patient showed significant improvement, with resolution of swelling and restoration of vision. This case highlights the critical importance of early diagnosis, timely imaging, and surgical and medical management integration in preventing vision-threatening complications of orbital abscesses caused by odontogenic infections in pediatric patients.