Periorbital cellulitis

Periorbital cellulitis

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What is periorbital cellulitis?

Periorbital cellulitis (also called preseptal cellulitis) is a serious but treatable infection of the eyelid and tissues around the eyeball. It usually affects only one eye and doesn't travel to the other. It's most common in children younger than 6 years.

© Dr. P. Marazzi / Science Source

What causes it?

Periorbital cellulitis is most likely to happen when infection-causing bacteria (like staphylococcus or streptococcus) are introduced into the eyelid by a scratch or a bug bite around the eye.

Other causes of periorbital cellulitis:

  • A sty, conjunctivitis, or a chalazion, which can cause it or make it worse.
  • A minor injury (or surgery) to the eye.
  • Another infection, such as sinusitis or an upper respiratory tract infection, that travels to the eye.

What are the symptoms of periorbital cellulitis?

If you notice any of these typical symptoms in your child, call the doctor right away:

  • Redness around the eye or in the white of the eye
  • Swelling of the eyelid, the white of the eye, or the area around the eye

The eye may also be tender, and your child may or may not have a fever.

Periorbital cellulitis doesn't usually cause vision problems or eye pain, although there may be a bit of discomfort.

How is it evaluated and treated?

The doctor will examine your child's eyes. If periorbital cellulitis is the diagnosis, don't be too alarmed – the condition is easily treated with medication and a few visits to the doctor. (Babies under 12 months of age may require a special evaluation for infection and a short hospital stay.)

The doctor will probably put your child on oral antibiotics, or even give a dose by injection in the office. Progress will be followed closely to make sure the drugs are working: Most likely you'll be asked to schedule an appointment for your little one in the next day or two, depending on the severity of the case.

A follow-up visit may also be scheduled a week or two later, at which point the infection should be gone. It may clear up in as little as 48 hours.

Even if your child's symptoms start to go away, make sure she completes the entire course of antibiotics to make sure the infection doesn't reappear. In the meantime, the doctor may suggest acetaminophen or (if your child is 6 months or older) ibuprofen to take the edge off any pain and bring down any fever.

Does periorbital cellulitis have any possible complications?

In rare cases, periorbital cellulitis progresses into orbital cellulitis, a serious eye condition that involves the deeper tissues around the eyeball. Unlike periorbital cellulitis, orbital cellulitis is a potentially sight- and life-threatening condition that requires immediate care.

Call the doctor immediately if you notice any of these after treatment for periorbital cellulitis (or at any time):

  • The eye becoming red or swollen
  • Symptoms getting worse instead of better
  • Fever developing along with other symptoms
  • Difficulty or pain with eye movement
  • Eye that appears to bulge or stick out
  • Vision changes

If untreated, orbital cellulitis can cause permanent vision problems, meningitis, or neurological problems in children. But if you follow through with the prescribed treatment and keep your follow-up appointments, this is highly unlikely. Play it safe and call the doctor if you have any concern about your child's symptoms.

Are there any ways to prevent periorbital cellulitis?

Making sure your child's immunizations are up to date is the most effective strategy.

In the past, the Haemophilus influenzae bacteria caused many cases of periorbital cellulitis. Thanks to the Hib vaccine, this is no longer the case. Another bacteria, Streptococcus pneumoniae, is a common cause that can be prevented by the pneumococcal vaccine.

Also, don't let other infections (such as sinus and dental) slide, as these can spread to the eyes and cause the condition.

Watch the video: Orbital Cellulitis an ocular emergency! (July 2022).


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