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by Martin JJ

Orbital Cellulitis

Definition

Orbital cellulitis is an infection around the eye. It affects the muscles and soft tissues around the eye.
It is a serious problem that will need treatment. If it is not treated, it can lead to blindness and nerve damage of 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

A bacteria causes the infection, it may enter the area after:
  • An injury to the area—bacteria can enter through broken skin
  • An infection in other area of the body like sinuses or mouth

Risk Factors

This infection is more common in children. Factors that increase the risk of getting orbital cellulitis include having:
  • Severe sinus or tooth infections
  • Infection of the bloodstream
  • Injury or surgery in the area

Symptoms

Symptoms of orbital cellulitis include:
  • Bulging eye
  • Painful eye movements
  • Tender or warm tissues around the eye
  • Swollen eyelids
  • Difficulty seeing when the eyelid is swollen
  • Fever
  • Headache
  • Runny nose
  • Double vision
  • Blurry vision

Diagnosis

The doctor will examine the eyes, teeth, and mouth. You will be asked about your health history. This is often enough info to make a diagnosis.
To look for the cause of the infection your doctor may also do the following:
  • Blood tests
  • Test fluid samples from the lining of your eye, nose, and throat
Images can show how far the infection has spread. Tests may include:

Treatment

Orbital cellulitis can get worse fast. A hospital stay is often needed. This will allow rapid change in treatment as needed.
Medication used to treat orbital cellulitis include:
  • Antibiotics—to treat the infection
  • Diuretics or eye drops—to help decrease pressure within the eyeball
  • Corticosteroids pills—to reduce inflammation, swelling, and pain
Pus may need to be drained. It may be taken from an infected sinus or orbit.

Prevention

Treat sinus or dental infections right away. This may prevent the spread to the eyes. Hib B vaccine may also help to 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
http://www.hc-sc.gc.ca

References

Distinguishing periorbital from orbital cellulitis. American Family Physician website. Available at: http://www.aafp.org/afp/2003/0315/p1349a.html. Accessed May 26, 2015.
Orbital cellulitis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115737/Orbital-cellulitis . Updated December 15, 2014. Accessed May 26, 2015.
Givner LB. Periorbital versus orbital cellulitis. Ped Infect Dis J. 2002;21(12):1157-1158.
1/5/2015 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115737/Orbital-cellulitis : Pushker N, Tejwani LK, Bajaj MS, Khurana S, Velpandian T, Chandra M. Role of oral corticosteroids in orbital cellulitis. Am J Ophthalmol. 2013;156(1):178-183.

Revision Information

  • Reviewer: David Horn, MD
  • Review Date: 05/2018
  • Update Date: 08/23/2018
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