DR. EESHITA JAIN

Dr. SHIVANAND BUBANALE, Dr. UMESH HARAKUNI, Dr. Smitha K.S., DR. SAMANTHA GOMES

Abstract

A 35-year-old man with uncontrolled diabetes presented with right-sided post covid rhino-orbital mucormycosis. On presentation, he had right-sided Bells palsy, ptosis, and total ophthalmoplegia. Right eye Visual Acuity was Counting Finger 2m.

TREATMENT

Intravenous antifungals, functional endoscopic sinus debridement in conjunction with a total of 9 transcutaneous retrobulbar amphotericin B(TRAMB) injections which were given in sets of 3 (once daily) at variable intervals.

The drawback of systemic antifungals is their limited tissue penetration which can be overcome by local administration of antifungals, thus reducing the burden of orbital disease.

liposomal and lyophilized AMB were used depending on its availability during the pandemic.

RESULT

On discharge, VA improved to 6/18 with partial improvement in extraocular movements.

CONCLUSION

TRAMB has a role in halting the progression of fungal orbital infection and improvement in visual acuity and partial restoration of ocular movements.