Orbital cellulite

Medical content revised by - Last revision 26/06/2019
Orbital cellulite

Orbital cellulite is an infection of the tissues of the orbit posterior to the orbital septum that can affect the eyelid, cheeks and eyebrows. This infection can be caused by local injuries (insect bites or penetrating eye injuries) or by the spread of contiguous facial infections.

This infection can become serious, causing even blindness of the patient, so that is very important to know the symptoms and treat them properly.

Likewise, it is important to differentiate orbital cellulites from periorbital or preseptal cellulites that occur in front of the orbital septum and not in it.


Causes of the orbital cellulite

Orbital cellulite is caused by the appearance of adjacent centres of damming infection that can be caused by:

  • An infection in the paranasal sinuses (eg i n case of sinusitis)
  • Penetrating eye trauma
  • The bite of an animal or an insect
  • An oral and/or tooth infection
  •  A dermatological infection on the face
  • Recent eye or facial surgery
  • An infection of the tear duct.



Symptoms of orbital cellulites

Factors to be taken into account to enhance this disease are:

Redness and swelling of the eyelids (erythema and oedema) together with any of the following symptoms:

  • Anterior displacement of the eyeball
  • Double vision (diplopia)
  • Decrease in ocular motility
  • Presence of fever
  • Loss of vision (infrequent)
  • Eye pain
  • Signs of primary infection (nasal discharge and sinusitis)

How it is diagnosed?

If you notice any of these symptoms, it is very important to go quickly to the ophthalmologist to make a diagnosis. He will explore your eyes, nose, eyelids and face.

The diagnosis will be mainly made after the following results:

  • Clinical evaluation: the ophthalmologist will review your eye pressure, the motility of the eyes and the state of your vision. The specialist can request a blood analysis or a culture of liquids to determine the type of bacteria that causes the infection (treptococcuspneumoniae, staphylococcusaureus, Streptococcuspyogenes,etc).
  • Imaging tests: if the clinical evaluation is not enough, you can prescribe a computerized axial tomography of, less frequently, an MRI to observe the magnitude of the infection and the affected areas.


Orbital cellulite treatment

Once the pathology has been diagnosed, the ophthalmologist will proceed to prescribe the most appropriate treatment.

Preseptal cellulites is treated with oral antibiotics and on an outpatient basis (the patient is not admitted into the hospital)

Orbital cellulite is usually treated in a hospital setting. The treatment includes:

  • Systemic antibiotics: they are usually administered intravenously and serve to attack the bacterial infection.
  • Steroids: can be prescribed to reduce inflammation or swelling caused by the infection several days after starting the antibiotic
  • Analgesics: are given to relieve pain.

Likewise, in some cases it will be necessary to resort surgery to decompress the orbit and perform a fluid drainage and abscess if the infection does not improve with pharmacological treatment.


How to prevent orbital cellulites?

The cause of this pathology is usually the extension of a contiguous infection or an infection provoked by a penetrating ocular traumatism.

Therefore, before any sign of having an infection in the area of the face, it is necessary to go urgently to the doctor to prevent its spread.

It is recommended to use the appropriate safety equipment if sports or work activities, that may undermine a risk for our eyes, are carried out.

This pathology commonly affects children. It is important to be vigilant if children show any type of symptom that may indicate an infection, especially in the case of those children who are prone to sinusitis.


Ophthalmologists specializing in Orbit and oculoplastics

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