Orbital vs Preorbital Cellulitis

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, chemosis, 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