Orbital Cellulitis | Preorbital cellulitis (preseptal cellulitis) |
Medical emergency as bacterial infection of tissues lying posterior to the orbital septum (within the orbit) can cause
severe sight and life-threatening emergency
| Localised infection of tissues lying anterior to the orbital septum |
Swollen eyelids, fever, chaemosis, history of facial laceration, trauma, insect bite, or sinusitis. | same as orbital cellulitis |
Ophthalmoplegia, proptosis, severe eye pain especially on eye movement, blurred vision or decreased visual acuity, diplopia.
| Skin erythema, lid oedema, warmth and tenderness, ptosis, pyrexia. No proptosis, normal vision, no pain moving eyes. Localised pain and swelling but eye unaffected |
Streptococcus pneumoniae, Haemophilus influenzae type b, and staphylococci or streptococci with a history of trauma | same as orbital cellulitis |
Orbital cellulitis can extend into the skull with resulting meningitis, vein thromboses, and blindness. | Extension beyond or into skull uncommon |
Computed tomography (CT) scan can help determine the extent of the infection (i.e., preorbital vs. orbital) and exclude complications such as an abscess. | same as orbital cellulitis |
Refer to Ophthalmologist same day. Co-manage with ENT. Treat either condition with blood cultures and administration of broad-spectrum antibiotics to cover the likely bugs until culture results are known. Will need IV antibiotics and Inpatient care initially | Same as orbital cellulitis though Oral antibiotics and ambulatory care may be fine depending on severity |