Orbital cellulitis

Question 1

Orbital cellulitis includes two basic types

Answer 1

1. periorbital (or preseptal)
2. orbital (or post-septal) cellulitis

usually found in children.

Question 2

Orbital (post-septal) cellulitis

Features

Answer 2

A potentially blinding and life-threatening condition

In children blindness can develop in hours

Unilateral swollen eyelids; may be red

An unwell patient

Tenderness over the sinuses (see Fig. E7)

Restricted and painful eye movements

Usually secondary to ethmoiditis

Usually caused by H. influenzae

Question 3

Important signs in the patient presenting with orbital (post-septal) cellulitis

Answer 3

Question 4

Periorbital (pre-septal) cellulitis

Answer 4

Similar presentation

Usually follows an abrasion but

No pain or restriction of eye movement

Question 5

Management (both types)

Answer 5

Immediate specialist referral

IV cefotaxime until afebrile, then amoxycillin/clavulanate or di(flu) cloxacillin for 7–10 d