Preseptal Cellulitis

Preseptal cellulitis is an infection of the eyelid and the tissues around the eye (periorbital area). The infection causes painful swelling and redness. This condition may also be called periorbital cellulitis.

In most cases, the condition can be treated with antibiotic medicine at home. It is important to treat preseptal cellulitis right away so that it does not get worse. If it gets worse, it can spread to the eye socket and eye muscles (orbital cellulitis). Orbital cellulitis is a medical emergency.

What are the causes?

Preseptal cellulitis is most commonly caused by bacteria. In rare cases, it can be caused by a virus or fungus. The germs that cause preseptal cellulitis may come from:

• A sinus infection that spreads near the eyes.
• An injury near the eye, such as a scratch, animal bite, or insect bite.
• A skin rash that becomes infected, such as eczema or poison ivy.
• An infected pimple on the eyelid (stye).
• Infection after eyelid surgery or injury.

What increases the risk?

You are more likely to develop this condition if:

• You have a weakened disease-fighting system (immune system).
• You have a medical condition that raises your risk for sinus infections, such as nasal polyps.

What are the signs or symptoms?

Symptoms of this condition usually develop suddenly. Symptoms may include:

• Eyelids that are red and swollen and feel unusually hot.
• Fever.
• Difficulty opening the eye.
• Headache.
• Facial pain.

How is this diagnosed?

This condition may be diagnosed based on your symptoms, your medical history, and an eye exam. You may have tests, such as:

• Blood tests.
• CT scan.
• MRI.

How is this treated?

This condition is treated with antibiotic medicines. These may be given by mouth (orally), through an IV, or as a shot. In rare cases, you may need surgery to drain an infected area.

Follow these instructions at home:

Medicines

• If you were prescribed an antibiotic to take at home, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
• Take over-the-counter and prescription medicines only as told by your health care provider.

Eye Care

• Do not use eye drops without first getting approval from your health care provider.
• Do not touch or rub your eye. If you wear contact lenses, do not wear them until your health care provider approves.
• Keep the eye area clean and dry.
• Wash the eye area with a clean washcloth, warm water, and baby shampoo or mild soap.
• To help relieve discomfort, place a clean washcloth that is wet with warm water over your eye. Leave the washcloth on for a few minutes, then remove it.

General instructions

• Wash your hands with soap and water often. If soap and water are not available, use hand sanitizer.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Drink enough fluid to keep your urine pale yellow.
• Ask your health care provider if it is safe for you to drive.
• Stay up to date on your vaccinations.
• Keep all follow-up visits as told by your health care provider. This includes any visits with an eye specialist (ophthalmologist) or dentist. This is important.

Get help right away if:

• You have new symptoms.
• Your symptoms get worse or do not get better with treatment.
• You have a fever.
• Your vision becomes blurry or gets worse in any way.
• Your eye looks like it is sticking out or bulging out (proptosis).
• You have trouble moving your eyes.
• You have a severe headache.
• You have neck stiffness or severe neck pain.

Summary

• Preseptal cellulitis is an infection of the eyelid and the tissues around the eye.
• Symptoms of preseptal cellulitis usually develop suddenly and include red and swollen eyelids, fever, difficulty opening the eye, headache, and facial pain.
• This condition is treated with antibiotic medicines. Do not stop taking the antibiotic even if you start to feel better.