Orbital Cellulitis

An infection in the eye socket (orbit) that contains the eyeball, some fat and eye muscles is called orbital cellulitis. This must be distinguished from a preseptal or periorbital cellulitis, an infection which involves the front of the eyelid.

In both orbital and preseptal cellulitis, eye symptoms may be similar, such as pain, swelling and redness. However, cellulitis of the eyelid is a milder condition compared to orbital cellulitis, which may lead to loss of vision and other serious complications. The clinical features of orbital cellulitis include pain and weakness of eye movements as well as abnormal protrusion of the eye (proptosis). Orbital cellulitis is less common than preseptal cellulitis, but both tend to occur more in children than in adults.

What Are the Symptoms of Orbital Cellulitis?

Symptoms of orbital cellulitis may include:

  • Pain and swelling of the upper and lower eyelids, as well as the cheek and eyebrow
  • Bulging of the eye
  • Reduced vision
  • Pain when moving the eye
  • High fever (102° F or higher)
  • General feeling of being ill
  • Shiny, purple or red eyelid

When to See a Doctor

Contact your doctor if:

  • There is swelling or redness around or in your eye
  • You have fever
  • You experience headache, stuffy nose, pain and tenderness around your eye, nose, and forehead
  • You want to ask questions about your condition/care

Seek immediate medical help if you experience any of the following:

  • Increased drowsiness or confusion
  • Numbness in your forehead
  • Stiff neck, vomiting
  • Double or blurred vision
  • Loss of vision
  • Inability to move the eye

What Are the Causes & Risk Factors of Orbital Cellulitis?

Cellulitis of the eye may be caused by a sinus infection that involves Haemophilus influenza. This is common, especially in young children. However, children with HiB (H. influenzae B) vaccine are less likely to be affected.

Other bacteria that may cause orbital cellulitis include Streptococcus pneumoniae, Staphylococcus aureus, and beta-hemolytic strep.

It is important for children to get immediate treatment for orbital cellulitis because their condition may get worse rapidly and lead to blindness.

Risk Factors

Factors that may increase your risk of developing orbital cellulitis include:

  • Sinus infection
  • Eye injury
  • Recent eye surgery
  • Deep tooth infection
  • Infection in the skin of the face or around the eye

How Is Orbital Cellulitis Diagnosed?

After taking your medical history, your doctor will examine your eye and find the area of inflammation. Most doctors can make a diagnosis of orbital cellulitis after a thorough clinical examination. If you are experiencing vision problems or pain, your doctor may request for a blood test and lab examination of the eye drainage to determine if the infection has spread to the eye. Imaging exams of the eye using computed tomography or CT scan can help determine the extent of inflammation and eye involvement.

What Are the Treatments for Orbital Cellulitis?

Orbital cellulitis is a serious condition and you may need to stay in the hospital for treatment.

Medications include:

  • Intravenous antibiotics to treat the infection, which may be given for up to ten days.
  • Pain medicines, which may be prescribed to reduce discomfort.
  • Steroids, which are prescribed to reduce eye inflammation.

Surgery may be needed to drain infected sinuses if your condition does not improve.

How to Manage Symptoms

You can take following measures to manage your symptoms:

  • Get enough rest and gradually increase activities each day.
  • Apply a warm, damp cloth over the affected eye as often as directed.

What Are the Risks of Orbital Cellulitis?

Orbital cellulitis can develop serious complications even with prompt treatment. With cellulitis, eye involvement may lead to blindness due to spread of infection. The other eye may also be affected, as well as the brain. Blood clots and infection may develop in the brain, which is a life-threatening condition.

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