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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 specific 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.

RESOURCES:

National Eye Institute (NEI)
https://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. American Family Physician website. Available at: http://www.aafp.org/afp/2003/0315/p1349a.html. Accessed May 26, 2015.

Orbital cellulitis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115737/Orbital-cellulitis. Updated December 15, 2014. Accessed May 26, 2015.

Givner LB. Periorbital versus orbital cellulitis. Ped Infect Dis J. 2002;21(12):1157-1158.

1/5/2015 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115737/Orbital-cellulitis: Pushker N, Tejwani LK, Bajaj MS, Khurana S, Velpandian T, Chandra M. Role of oral corticosteroids in orbital cellulitis. Am J Ophthalmol. 2013;156(1):178-183.



Last reviewed May 2016 by David Horn, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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