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These conditions refer to an inflammation and infection of the tissue and skin that surround the eye. They are serious infections that involve the eye and the structures around the eye. Periorbital cellulitis involves the area from the skin of the eyelid to the bony area that encloses the eye. Orbital cellulitis is an infection that involves the eye and the eye structures within the bony cavity of the face. Both of these conditions are serious and require immediate medical attention by your child's physician.
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The most common cause of these types of cellulitis is from an infection with bacteria. The following are the bacteria that are usually involved:
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- Staphylococcus aureus
- Streptococcus pyogenes
- Haemophilus influenzae
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The bacteria gets into the eye and the surrounding cavity many different ways. The two most common ways the infection gets into the eye include the following:
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- trauma - Direct trauma to the eye can lead to infection from the bacteria.
- spread from other areas - Most commonly, the infection begins in the sinuses. The sinuses are cavities, or air-filled pockets, that are near the nasal passage.
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The following are the most common symptoms of periorbital cellulitis. However, each child may experience symptoms differently. Symptoms appear abruptly and may include:
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- swelling of the upper and lower eyelid
- redness of the upper and lower eyelid
- pain
- fever
- general discomfort of the eye
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The eyeball is usually not affected and appears normal.
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The following are the most common symptoms of orbital cellulitis. However, each child may experience symptoms differently. Symptoms appear slowly and may include:
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- swelling of the upper and lower eyelid
- eyeball becomes swollen and bulges
- decrease in the child's ability to move the eyeball
- decrease in vision
- fever
- general discomfort
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The symptoms of periorbital/orbital cellulitis may resemble other eye conditions or medical problems. Always consult your child's physician for a diagnosis.
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Diagnosis is usually based on a complete medical history and physical examination of your child. In addition, your child's physician may order the following tests to help confirm the diagnosis:
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- blood tests
- x-ray - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
- computerized tomography scan (Also called a CT or CAT scan.) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
- cultures of the drainage from the eyes
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Specific treatment for periorbital cellulitis will be determined by your child's physician based on:
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- your child's age, overall health, and medical history
- the extent of the condition
- your child's tolerance for specific medications, procedures, or therapies
- expectations for the course of the condition
- your opinion or preference
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Treatment will usually include oral antibiotics. Close follow up with your child's physician is necessary for constant monitoring.
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Specific treatment for orbital cellulitis will be determined by your child's physician based on:
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- your child's age, overall health, and medical history
- the extent of the condition
- your child's tolerance for specific medications, procedures, or therapies
- expectations for the course of the condition
- your opinion or preference
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Orbital cellulitis is a serious condition and must be treated promptly. Treatment may include:
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- consultation with an ophthalmologist (eye care specialist)
- hospitalization - Your child may be admitted to the hospital for antibiotics through an intravenous (IV) catheter. Hospitalization also allows for close evaluation of your child and the condition.
- surgery - Surgical drainage of the sinuses or any abscesses of the eye is sometimes needed.
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The risk of complications may be reduced with prompt and accurate treatment of the problem. The following are some of the more common complications that may occur:
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- meningitis (an infection of the outside of the brain and the spinal cord)
- loss of vision
- brain abscess (with the possibility of permanent neurologic deficits)
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Orbital Cellulitis
