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Definition

Orbital cellulitis is a serious infection of the bony cavity in which the eyeball sits. This cavity is called the orbit. It is surrounded by 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. It causes the eyeball to have a swollen appearance. If the infection is not treated, it can lead to blindness.

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 certain bacteria.

Risk Factors

Factors that increase your risk of getting orbital cellulitis include:

  • Age: Children are at high risk of severe infections that could result in blindness
  • Infections that spread from areas surrounding the eye, such as the 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

Doctors can often recognize orbital cellulitis by examining your 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 often requires hospitalization. Treatment for orbital cellulitis includes:

  • Antibiotics are given to treat the infection. They will be started right away, even before results from the laboratory have come back. Antibiotics are generally given by mouth for three weeks. If the infection is serious, antibiotics may be given through an IV for at least several days.
  • Diuretics or eye drops are given to help decrease pressure within the eyeball.
  • Surgery may be performed to drain a pus collection from an infected sinus or orbit.

If you are diagnosed with orbital cellulitis, follow your doctor's instructions.

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, which will prevent most of the Haemophilus influenzae type B infections.

RESOURCES:

National Eye Institute
http://www.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. Am Fam Physician. 2003 Mar 15;67(6):1349-1353. American Family Physician website. Available at: http://www.aafp.org/afp/2003/0315/p1349a.html. Accessed July 25, 2013.

Orbital cellulitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 13, 2012. Accessed July 25, 2013.

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

Periorbital cellulitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 14, 2010. Accessed July 25, 2013.

Preseptal and orbital cellulitis. Pediatric Care Online website. Available at: http://www.pediatriccareonline.org/pco/ub/view/Point-of-Care-Quick-Reference/397218/0/Preseptal_and_Orbital_Cellulitis. Updated March 8, 2010. Accessed July 25, 2013.



Last reviewed June 2014 by Eric Berman, 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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