Opthalmology - Preorbital Cellulitis

Question 1

Definition

Answer 1

Infective oedema of the eyelids and periorbital skin with no involvement of the orbit.
- inflammation and infection remains confined to the soft tissue layers superficial to the orbital septum

Question 2

Aetiology + Risk factors

Answer 2

Aetiology:
- Staph Aureus
- Strep Pneumoniae
- Haemophillus influenzae
Risk factors:
- Boys
- Previous sinus infection
- Lack of Hib vaccination
- Recent eyelid injury

Question 3

Signs and symptoms

Answer 3

Unilateral eyelids swelling and erythema
Unilateral eye pain/tenderness
Fever/malaise/irritability
Ptosis
Consider history of foreign body or traumatic eye injury

Question 4

What to differentiate it from

Answer 4

• orbital cellulitis → affect sight
• presents with more ocular pain, decreseed vision, proptosis
• emergency
• CT SCAN TO DISTINGUISH

Question 5

Investigations

Answer 5

• Clinical
• CT sinus and orbits with contrast -> differentiate from orbital cellulitis
• WBC -> increased neutrophils

Question 6

Management

Answer 6

Oral co-amoxiclav

Question 7

Complications

Answer 7

Develop into orbital cellulitis so vulnerable patients or severe cases may require admission for monitoring