Orbital Cellulitis

Orbital cellulitis is an infection of the soft tissues of the orbit. The most common cause is the spread of an infection of the ethmoid sinuses. However, it can also occur as a result of direct infection cause by orbital trauma or surgery. Bacteria in the blood can also spread and cause optical cellulitis. The first picture above is of a patient with optical cellulitis of the left eye. (emedicine.com) The second image is an axial slice CT image of a patient with optical cellulitis. (Also from emedicine.com) This infection is most common in winter due to the increase in sinusitis. Children are more likely than adults to be affected. Some symptoms include lid edema, orbital pain, fever, headache, decreased vision, increased intra-ocular pressure and inability to open the eye.

To diagnose orbital cellulitis lab test are done as well as imaging studies. Lab tests include CBC, blood cultures and smear for Gram stain and culture of nasal discharge. A high resolution CT scan with pre and post contrast images are used with axial and coronal slices.

Treatment for orbital cellulitis is antibiotics for the infection, diuretics for increased intra-ocular pressure, nasal decongestant if cellulitis is secondary to sinusitis, and an antifungal if the cellulitis is attributed to a fungus.