The man in the photo below presents to the ER with severe pain in the right eye that began the same morning. His CT scan is also seen below. He has no previous history of trauma. Which of the following is not true of the situation?

Correct Answer: The best treatment for this patient is steroids.

The photo shows right proptosis, erythema and edema. Based on the picture and history, one cannot differentiate between and infectious and inflammatory process. The CT scan shows diffuse ethmoid sinus disease and a subperiosteal abscess along the medial wall, which causes non-axial displacement of the globe. This is evidence for orbital cellulitis that should be treated with antibiotics. Steroids are the treatment for idiopathic orbital inflammation. Both orbital infection and inflammation can lead to an exudative retinal detachment.