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by Martin JJ

Orbital Cellulitis

Definition

Orbital cellulitis is a serious infection of the bony cavity in which the eyeball sits and the muscles and soft tissues that surround the eyeball. This cavity is called the orbit. It is surrounded by the sinuses. The sinuses are the hollow areas of the skull around the nose. Orbital cellulitis affects not only the eye, but also the eyelids, eyebrows, and cheeks.
If the infection 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

Orbital cellulitis is caused by certain bacteria.

Risk Factors

This condition is more common in children. Factors that increase the risk of getting orbital cellulitis include:
  • Infections that spread from areas surrounding the eye, such as the eyelids, sinuses, mouth and teeth, and face
  • Infections that spread from the bloodstream
  • Injury or surgery in the area
  • Stye on the eyelid
  • Bug bite or sting to the eyelid

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

Orbital cellulitis can often be diagnosed by examining the eyes, teeth, and mouth. Your medical and family history will be taken.
Your bodily fluids may be tested. This can be done with:
  • Blood tests
  • Testing samples from the lining of your eye, nose, and throat
Images may be taken of your bodily structures. This can be done with:

Treatment

Orbital cellulitis can worsen quickly. It usually requires hospitalization.

Medication

Medication used to treat orbital cellulitis include:
  • Antibiotics to treat the infection
  • Diuretics or eye drops to help decrease pressure within the eyeball
  • Oral corticosteroids to reduce inflammation, swelling, and pain

Surgery

In some cases, surgery may be done to drain a pus collection from an infected sinus or orbit.

Prevention

Treating sinus or dental infections right away may prevent them from spreading to the eyes. In addition, children should be protected with the Hib B vaccine, which will prevent most of the Haemophilus influenzae type B infections.

RESOURCES

National Eye Institute
http://www.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. Am Fam Physician. 2003 Mar 15;67(6):1349-1353. American Family Physician website. Available at: http://www.aafp.org/afp/2003/0315/p1349a.html. Accessed May 26, 2015.
Orbital cellulitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 15, 2014. Accessed May 26, 2015.
Givner LB. Periorbital versus orbital cellulitis. Ped Infect Dis J. 2002; 21:1157-1158.
1/5/2015 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Pushker N, Tejwani LK, et al. Role of oral corticosteroids in orbital cellulitis. Am J Ophthalmol. 2013;156(1):178-183.

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