Orbital Cellulitis

What is an Orbital Cellulitis

Orbital cellulitis is an infection in the eye socket (orbit) and the tissues that surround the eye. The infection can spread to the eyelids, eyebrow area, and cheek.

It can also cause a pocket of pus to develop around the eye (orbital abscess). In severe cases, the infection can spread to the brain. Orbital cellulitis is a medical emergency.

What are the causes?

The most common cause of this condition is a bacterial infection. The infection usually spreads to the eye socket from another part of the body. The infection may start in one of these places:

  • Nose or sinuses.
  • Eyelids.
  • Facial skin.
  • Bloodstream.

What increases the risk?

You are more likely to develop this condition if you recently had one of the following:

  • Upper respiratory infection. This affects the nose, throat, and upper air passages.
  • Sinus infection.
  • Eyelid or facial infection.
  • Tooth infection.
  • Eye injury or an object on the surface of the eye or in the eyeball that should not be there (foreign body).
  • Infection that affects the entire body or the bloodstream (systemic infection).

What are the signs or symptoms?

Symptoms of this condition usually start quickly. Symptoms may include:

  • Eye pain that gets worse with eye movement.
  • Swelling around the eye.
  • Eye redness.
  • Bulging of the eye.
  • Inability to move the eye.
  • Double vision or decreased vision.
  • Fever.

How is this diagnosed?

This condition may be diagnosed based on your symptoms and an eye exam. You may also have tests to confirm the diagnosis and to check for an orbital abscess. Other tests (cultures) may be done to find out which specific bacteria are causing the infection. Tests may include:

  • Complete blood count (CBC).
  • Blood culture.
  • Nose, sinus, or throat culture.
  • Imaging studies, such as a CT scan or MRI.

How is this treated?

This condition is usually treated in a hospital. Antibiotic medicines are given directly into a vein through an IV.

  • At first, you may get IV antibiotics to kill bacteria that often cause orbital cellulitis (broad spectrum antibiotics).
  • Your medicine may be changed if the culture test results suggest that another antibiotic would be better.
  • If the IV antibiotics are working to treat your infection, you may be switched to oral antibiotics and allowed to go home.
  • In some cases, surgery may be needed to drain an orbital abscess.

Follow these instructions at home:

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Take your antibiotic medicine as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You have questions about your medicines.
  • Your pain is not well-controlled.

Get help right away if:

  • Your eye pain or swelling returns or it gets worse.
  • You have any changes in your vision.
  • You develop a fever.
  • You have vomiting.
  • You develop a severe headache or numbness in your face.

Summary

  • Orbital cellulitis is an infection in the eye socket (orbit) and the tissues that surround the eye. The infection can spread to other areas.
  • Symptoms usually start quickly. Some of the symptoms include eye pain that gets worse with movement, redness and swelling around the eye, and double or decreased vision.
  • Orbital cellulitis is a medical emergency, and it requires IV antibiotics for treatment.
  • See your health care provider right away if your symptoms return or get worse.
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