Orbital Cellulitis

Question 1

What is Orbital Cellulitis?

Answer 1

An infection around the eyeball that involves the tissues behind the orbital septum - a medical emergency.

Question 2

Risk Factors of Orbital Cellulitis (5).

Answer 2

1. Young Age.
2. Previous Sinus Infection.
3. Lack of HiB Vaccination.
4. Recurrent Eyelid Infection/Peri-Orbital Cellulitis.
5. Ear/Facial Infection.

Question 3

ORBITAL CELLULITIS vs. Peri-Orbital Cellulitis (5).

Answer 3

1. Ophthalmoplegia.
2. Reduced Eye Movement.
3. Changes in Vision.
4. Abnormal Pupil Reaction.
5. Proptosis (Forward Movement of Eyeball).

Question 4

Epidemiology of Orbital Cellulitis.

Answer 4

Mean age of hospitalisation is 7-12 years.

Question 5

Aetiology of Orbital Cellulitis.

Answer 5

Infection affecting the fat and muscles posterior to the orbital septum, within the orbit and not involving the globe, usually caused by a spreading URTI from the sinuses.

Question 6

Clinical Features of Orbital Cellulitis (6).

Answer 6

1. Redness and Swelling around Eye.
2. Severe Ocular Pain.
3. Visual Disturbance.
4. Proptosis.
5. Ophthalmoplegia (Pain on Eye Movement).
6. Eyelid Oedema and Ptosis.

Question 7

Investigations of Orbital Cellulitis (2).

Answer 7

1. CT Contrast - Inflammation of Orbital Tissues Deep to Septum and Sinusitis.
2. Blood Cultures/Microbiological Swabs.

Question 8

Commonest causative organisms of Orbital Cellulitis (3).

Answer 8

1. Streptococci.
2. S. aureus.
3. Haemophilus Influenza type B.

Question 9

Management of Orbital Cellulitis (3).

Answer 9

1. Admission.
2. IV Antibiotics.
3. Surgical Drainage - Abscess.

Question 10

Prognosis of Orbital Cellulitis (2).

Answer 10

1. Visual Loss - Compression of Optic Nerve/Neuritis.

2. Death - Cavernous Sinus Thrombosis or Intracranial Spread of Infection.