Orbital and Periorbital Celulitis

Question 1

What is periorbital cellulitis?

Answer 1

An infection of the eyelid and surrounding soft tissues anterior to the orbital septum.

Question 2

What is orbital cellulitis?

Answer 2

A serious infection involving the soft tissues of the orbit posterior to the orbital septum.

Question 3

What is the main difference between periorbital and orbital cellulitis?

Answer 3

Periorbital cellulitis affects tissues anterior to the orbital septum, while orbital cellulitis is posterior.

Question 4

What are the common causes of periorbital cellulitis?

Answer 4

Trauma, insect bites, or spread from adjacent skin infections like impetigo.

Question 5

What are the common causes of orbital cellulitis?

Answer 5

Sinusitis, particularly ethmoid sinusitis, or spread from adjacent structures.

Question 6

What are the typical symptoms of periorbital cellulitis?

Answer 6

Eyelid swelling, redness, and tenderness, but no proptosis or restriction of eye movements.

Question 7

What are the typical symptoms of orbital cellulitis?

Answer 7

Painful eye movements, proptosis, vision changes, and fever.

Question 8

What is the prevalence of periorbital and orbital cellulitis?

Answer 8

Both are relatively uncommon, with orbital cellulitis being less common but more serious.

Question 9

What are the risk factors for orbital cellulitis?

Answer 9

Sinusitis, trauma, recent surgery, or immunosuppression.

Question 10

What are the complications of untreated orbital cellulitis?

Answer 10

Vision loss, abscess formation, cavernous sinus thrombosis, or intracranial spread.

Question 11

What are the key clinical signs of periorbital cellulitis?

Answer 11

Eyelid swelling and erythema without proptosis or restricted eye movements.

Question 12

What are the key clinical signs of orbital cellulitis?

Answer 12

Proptosis, restricted and painful eye movements, decreased vision, and possibly systemic signs of infection.

Question 13

What investigations are necessary for orbital cellulitis?

Answer 13

CT scan of the orbits and sinuses, blood tests (e.g., FBC, CRP), and microbiological cultures.

Question 14

What is the first-line treatment for periorbital cellulitis?

Answer 14

Oral antibiotics for mild cases; intravenous antibiotics if severe or in high-risk patients.

Question 15

What is the first-line treatment for orbital cellulitis?

Answer 15

Intravenous antibiotics and urgent ophthalmology review.

Question 16

What antibiotics are commonly used for orbital cellulitis?

Answer 16

Broad-spectrum IV antibiotics such as ceftriaxone and metronidazole or piperacillin-tazobactam.

Question 17

What is the role of imaging in orbital cellulitis?

Answer 17

CT imaging identifies the extent of infection and complications like abscess formation.

Question 18

How is an orbital abscess managed?

Answer 18

Drainage via surgical intervention, often combined with antibiotics.

Question 19

What are the differential diagnoses for orbital cellulitis?

Answer 19

Periorbital cellulitis, allergic reactions, dacryocystitis, or cavernous sinus thrombosis.

Question 20

What is the orbital septum?

Answer 20

A fibrous membrane that separates the eyelid from the orbital contents, acting as a barrier to infection.

Question 21

What clinical features help differentiate orbital from periorbital cellulitis?

Answer 21

Orbital cellulitis involves proptosis, painful eye movements, and vision changes, while periorbital does not.

Question 22

What are potential long-term complications of orbital cellulitis?

Answer 22

Permanent vision loss or strabismus due to damage to orbital structures.

Question 23

What is cavernous sinus thrombosis, and how is it related to orbital cellulitis?

Answer 23

A rare but life-threatening complication where infection spreads to the cavernous sinus, causing systemic symptoms.

Question 24

What are signs of intracranial spread in orbital cellulitis?

Answer 24

Severe headache, altered mental status, neurological deficits, or seizures.

Question 25

Why is prompt treatment crucial in orbital cellulitis?

Answer 25

Delayed treatment increases the risk of serious complications, including blindness and intracranial spread.