Necrotizing fasciitis is an uncommon yet potentially lethal condition that warrants prompt intervention. Its occurrence in the periorbital region is rare. Several unique anatomical features of the eyelids give rise to relatively lower mortality, yet its close proximity to the ocular apparatus poses special challenges in the management of the condition. In the current report, we present the first reported case of bilateral upper eyelids necrotizing fasciitis in Hong Kong, managed with early debridement and antibiotics coverage. The patient survived with preservation of vision.
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