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Orbital Cellulitis

Definition

Orbital cellulitis is an infection. It affects the muscles and tissues around the eye.

If not treated, it can lead to blindness and nerve damage in the face.

Eyeball in Orbit
Eye bone socket nerve

The cavity below the eye is a sinus, the most common place for the infection to start.

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Causes

Bacteria cause the infection. They may enter from:

  • Broken skin—due to an injury to the area
  • An infection in another part of the body—like the sinuses or mouth

Risk Factors

This infection is more common in children. Things that raise the risk are:

  • Sinus or tooth infections
  • Infection of the bloodstream
  • Injury or surgery in the area

Symptoms

Symptoms of orbital cellulitis are:

  • Vision problems
  • Problems moving the eye
  • Bulging eye
  • Pain and redness around the eye
  • Swollen eyelids
  • Fever
  • Headache
  • Tiredness

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. The doctor will check the eyes, teeth, and mouth. This may be enough to make a diagnosis.

Tests may include:

  • Blood tests
  • Fluid samples from the eye, nose, and throat

Images can show how far the infection has spread. Tests may be:

Treatment

Orbital cellulitis can get worse fast. A hospital stay is often needed.

Medicines will be given, such as:

  • Antibiotics—to treat the infection
  • Diuretics or eye drops—to help decrease pressure in the eyeball
  • Corticosteroids pills—to reduce inflammation, swelling, and pain

Pus may need to be drained. It may be taken from the sinus or eye area.

Prevention

This problem may be prevented by treating sinus or dental infections right away. The Hib B vaccine may also help protect children.

RESOURCES:

National Eye Institute (NEI)
https://nei.nih.gov

Retina International
http://www.retina-international.org

CANADIAN RESOURCES:

Canadian Ophthalmological Society
http://www.cos-sco.ca

Health Canada
https://www.canada.ca

REFERENCES:

Distinguishing periorbital from orbital cellulitis. American Family Physician website. Available at: http://www.aafp.org/afp/2003/0315/p1349a.html. Accessed February 4, 2021.

Jiramongkolchai P, Lander DP, et al. Trend of surgery for orbital cellulitis: An analysis of state inpatient databases. Laryngoscope. 2020;130(3):567-574.

Orbital cellulitis. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/orbital-cellulitis . Accessed February 4, 2021.

Last reviewed September 2020 by David Horn, MD  Last Updated: 2/4/2021