Ophthalmology

Question 2

Orbital cellulitis

1. Risk factors
2. Presentation
3. Differentiating orbital from preseptal cellulitis
4. Investigations
5. Management

Answer 2

1. Childhood: 7-12 years; previous sinus infection; Lack fo Hib vaccination; recent eyelid infection/insect bite(periorbital cellulitis); ear or facial infection
2. redness and swelling around eye, severe ocular pain, visual disturbance, proptosis, ophthalmoplegia, eyelid edema and ptosis, drowsiness+/-nausea/vomiting in meningeal involvement (rare)
3. reduced visual acquity, proptosis, opthalmoplegia
4. FBC, Ct contrast shows inflammation of orbital tissues deep to the septum, sinusitis, blood culturew and swab
5. IV antibiotics

*common bacterial causes - Streptococcus, Staph aureus, Haemophilus influenza B
*result of infection affecting fat and musclkes posterior to the orbital septum, within the orbit but not involving the globe.
*caused bu spreading URTI from sinuses.
*medical emergency
*Periorbital is superficial infection anteior to the orbital septum resulting from superficial tissue injury - chalazoin, insect bite