Homepage: EMNote.org ■
🚩Membership: tinyurl.com/joinemnote
🚩ACLS Lecture: tinyurl.com/emnoteacls
What is Orbital Cellulitis?
Orbital cellulitis is a serious infection of the soft tissues surrounding the eye, including the area behind the eye. It's a true ophthalmic emergency that can lead to severe complications if not promptly recognized and treated.
Signs and Symptoms.
Patients with orbital cellulitis typically present with a combination of the following signs and symptoms:
Severe, constant "eye pain" that worsens with eye movement or pressure.
Significant swelling and redness of the eyelids and area around the eye.
Bulging of the affected eye (proptosis) due to increased pressure within the orbit.
Fever, chills, and general feeling of illness.
Blurred vision, double vision, or complete vision loss in the affected eye.
Diagnosis.
To diagnose orbital cellulitis, a thorough clinical examination is essential, supported by imaging studies like CT or MRI scans. These scans help assess the extent of the infection, identify complications, and rule out other conditions that may mimic orbital cellulitis.
Potential Complications.
If left untreated or inadequately managed, orbital cellulitis can progress to life-threatening complications, including:
Cavernous sinus thrombosis, can result in severe neurological deficits and mortality.
Meningitis.
Brain abscess, presenting with focal neurological signs, seizures, and altered mental status.
Permanent vision loss due to elevated intraorbital pressure which compromises ophthalmic artery perfusion.
Common Pathogens.
While various bacteria can cause orbital cellulitis, some of the most common pathogens include:
Methicillin-Resistant Staphylococcus aureus (MRSA), Streptococcus species, and Haemophilus species
Management.
Treating orbital cellulitis requires a multi-pronged approach:
Intravenous antibiotics: Prompt initiation of broad-spectrum intravenous antibiotics targeting potential pathogens is crucial to stop the infection from spreading.
Surgical intervention: In some cases, surgical drainage of the infected area may be necessary to relieve pressure and remove the source of the infection.
Supportive care: Measures like pain relief, fever control, and steps to preserve vision are essential until the infection resolves.
Preseptal cellulitis and orbital cellulitis are two distinct infections involving the eye area, differing in their location and severity.
. . .
Preseptal cellulitis affects the eyelids and soft tissues anterior to the orbital septum, the membrane separating the eyelids from the eye socket. Common causes include injuries, insect bites, conjunctivitis, chalazion, and sinus infections. Symptoms typically involve eyelid swelling, redness, pain, and tenderness without vision issues or eye movement restriction. It generally follows a benign course and is treated with antibiotics and supportive care.
In contrast, orbital cellulitis is an infection within the eye socket itself, posterior to the orbital septum. It often arises from the spread of a sinus infection, especially ethmoid sinusitis. Orbital cellulitis presents with sudden swelling of the eyelids and conjunctiva, eye movement pain, vision impairment, double vision, and fever. Left untreated, it can lead to severe complications like vision loss from increased intraocular pressure, permanent eye muscle dysfunction, cavernous sinus thrombosis, meningitis, and brain abscess. Prompt antibiotic therapy is essential, and surgical drainage may be required for abscesses or other complications.
In summary, while preseptal cellulitis is a relatively mild condition, orbital cellulitis is a potentially sight- and life-threatening emergency requiring urgent medical intervention. Recognizing the differences between these two conditions is critical for appropriate management and preventing permanent damage.