Figure 1

Iconographic evolution of the case. Panel 1: At presentation. A: Moderate swelling and redness of the left upper eyelid, and slight involvement of the lower eyelid preventing orbital opening. B: Complete opacity of the left ethmoid with air-fluid levels, non-homogeneous intraorbital fat thickening mainly on the mesial side (arrow), and inflammatory involvement of the peri-orbital soft-tissues. Panel 2: After two days. The upper eyelid redness and swelling slightly increased and there was a purulent conjunctival discharge (arrow). Panel 3: After 10 days. Reduced eyelid swelling albeit with the persistence of redness. Proptosis solved. Panel 4: After 40 days. Moderate upper eyelid swelling and redness persisted with asymmetrical in eyelid opening. Panel 5: After 60 days. Persistence of moderate upper eyelid swelling but without Redness; asymmetrical eyelid opening. Panel 6: After 90 days. Slight upper eyelid swelling with residual asymmetry in eyelid opening. Panel 7: After 150 days. Minimal upper eyelid swelling with residual asymmetry in eyelid opening. Panel 8: After 210 days. Complete clinical recovery.