A 14 yr male presents with pain and swelling to the left eye. Mother states he recently had a mild illness with cough and sinus congestion within the past 2 weeks. Over the past 3-4 days he has developed left eye pain and swelling.
He currently has a fever of 101.2 °F (38.4°C) and the rest of his vital signs are within normal limits.
Physical exam reveals proptosis and ophthalmoplegia, orbital pain and tenderness as well as a dark red discoloration of the eyelids, conjunctival chemosis and hyperemia of the conjunctiva.