ORBITAL CELLULITIS
Presentation
- Infection of the orbital soft tissues.
- Usually caused by extension of sinusitis.
- Affects older children (average, 12 years).
- Protrusion of the eyeball.
- Eyelids shiny and red or purple.
- Swollen lid impairs vision.
- Chemosis.
- Decreased visual acuity.
- Eye movements restricted and painful.
- Fever.
- Systemically unwell.
Management
- Sight and life threatening.
- Refer for intravenous antibiotics.
- May require surgery.
PERIORBITAL CELLULITIS
Presentation
- Affects the eyelids and periorbital soft tissues, but not the orbit of the eye.
- Caused by trauma to the eyelids, including insect bites, or bacteraemia.
- Eyelids red and swollen; warm and tender.
- Rarely progress to orbital cellulitis.
- Constitutionally well.- Vision tends to be ok.
- No protrusion of the eyeball.
- Affects younger children (average, 21 months)
Management
- Usually managed medically.
Contributed by Dr Vasa Gnanapragasam, a GP in Sutton, Surrey.
