Contents

SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferences

View all Images (10)

Emergency: requires immediate attention
Orbital cellulitis - External and Internal Eye
See also in: Overview,Cellulitis DDx
Other Resources UpToDate PubMed
Emergency: requires immediate attention

Orbital cellulitis - External and Internal Eye

See also in: Overview,Cellulitis DDx
Contributors: Lauren Patty Daskivich MD, MSHS, Brandon D. Ayres MD, Christopher Rapuano MD, Sunir J. Garg MD
Other Resources UpToDate PubMed

Synopsis

Orbital cellulitis is an infection of the soft tissues of the orbit posterior to the orbital septum that occurs as a result of the spread of a nearby infection, trauma, or hematogenous bacterial dissemination. Predisposing factors therefore include local eyelid infections (hordeola, dacryocystitis), sinusitis, upper respiratory tract infections, dental infections, otitis media, and eyelid trauma (insect bites, etc). It is a rare postseptal extension of preseptal cellulitis (inflammation of structures anterior to the orbital septum). Orbital cellulitis is more common in children but can be seen in any age group.

It presents clinically as eyelid erythema and edema with signs of orbital involvement. There may be associated fever, headache, nasal discharge, malaise, blurry or double vision, proptosis, or chemosis of the conjunctiva. The most common causative organisms are Staphylococcus and Streptococcus species, although fungi such as Mucor and Aspergillus may cause orbital cellulitis. The rate of this disease attributable to Haemophilus influenzae type b has dropped considerably since introduction of the Hib vaccine.

The complications of orbital cellulitis include permanent vision loss, orbital and subperiosteal abscesses, cavernous sinus thrombosis, meningitis, and cerebral abscesses, which can lead to death if not treated in a timely fashion.

Orbital cellulitis is a medical emergency and therefore must be distinguished from the milder preseptal cellulitis and other causes of eyelid erythema and edema. Signs of orbital involvement, such as proptosis and ophthalmoplegia (limited eye movement), are almost always present.

Codes

ICD10CM:
H05.019 – Cellulitis of unspecified orbit

SNOMEDCT:
194005002 – Orbital Cellulitis

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

To perform a comparison, select diagnoses from the classic differential

Subscription Required

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

References

Subscription Required

Last Reviewed:07/29/2019
Last Updated:07/29/2019
Copyright © 2024 VisualDx®. All rights reserved.
Emergency: requires immediate attention
Orbital cellulitis - External and Internal Eye
See also in: Overview,Cellulitis DDx
A medical illustration showing key findings of Orbital cellulitis : Eye pain, Fever, Diplopia, Periorbital edema, Unilateral distribution, Vision loss, Ocular trauma, Proptosis, Elevated intraocular pressure
Clinical image of Orbital cellulitis - imageId=3430812. Click to open in gallery.  caption: 'Marked edema and erythema of the upper eyelid with seropurulent discharge at the medial canthus and associated crusting.'
Marked edema and erythema of the upper eyelid with seropurulent discharge at the medial canthus and associated crusting.
Copyright © 2024 VisualDx®. All rights reserved.