Ocular adnexal injury and complications in orbital dog bites.

Orbital dog bites, though statistically uncommon, occur most frequently in children and are associated with severe ocular adnexal injury. Of 16 victims, two-thirds were under 10 and over half under 5 years of age. The wounds consisted of numerous periorbital punctures, and in most cases, full-thickness lid lacerations involving the tear system. There were no serious injuries to the globe. Reversible amblyopia occurred in two children under 3 years of age with damage to the levator muscle. One child suffered a naso-orbital fracture. Because of the obvious nature of the injury, most patients present early and can be managed well with meticulous wound care and primary surgical repair. The use of prophylactic antibiotics, though controversial, appears prudent in such cases. Ophthalmologists treating these injuries must be aware of serious potential complications including occult facial fracture or intracranial penetration in young children, septicemia caused by bacillus DF-2 in patients with prior splenectomy, tetanus, and rabies.