Orbital cellulitis

Orbital cellulitis is a dangerous infection, which can cause lasting problems.

The most common cause of this condition in children is a sinus infection (often Haemophilus influenzae. The infection used to be more common in young children, under the age of 7. It is now rare due to the HiB (Haemophilus influenzae B) vaccine.

The bacteria Staphylococcus aureus, Streptococcus pneumoniae, and beta-hemolytic streptococci may also cause orbital cellulitis.

Orbital cellulitis infections in children may get worse very quickly and can lead to blindness. Medical care is needed right away.

Symptoms may include:

• Painful swelling of upper and lower eyelid, and possibly the eyebrow and cheek
• Bulging eyes
• Decreased vision
• Eye pain, especially when moving the eye
• Fever, generally 102° F or higher
• General ill feeling
• Painful or difficult eye movements
• Shiny, red or purple eyelid

Tests commonly done include:

• CBC (complete blood count)
• Blood culture
• Spinal tap in affected children who are very sick

Other tests may include:

• X-ray of the sinuses and surrounding area
• CT scan or MRI of the sinuses and orbit
• Culture of eye and nose drainage
• Throat culture

In most cases, a hospital stay is needed. Treatment most often includes antibiotics given through a vein. Surgery may be needed to drain the abscess, or relieve pressure in the space around the eye.

An orbital cellulitis infection can get worse very quickly. A person with this condition must be checked every few hours.

With prompt treatment, the person can recover fully.

Complications may include:

• Cavernous sinus thrombosis (formation of a blood clot in a cavity at the base of the brain)
• Hearing loss
• Septicemia or blood infection
• Meningitis
• Optic nerve damage and loss of vision

Orbital cellulitis is a medical emergency that needs to be treated right away. Call your health care provider if there are signs of eyelid swelling, especially with a fever.

Getting scheduled HiB vaccine shots will prevent the infection in most children. Young children who share a household with a person who has this infection may need to take antibiotics to avoid getting sick.

Prompt treatment of a sinus or dental infection may prevent it from spreading to the eyes.