Orbital cellulitis

Orbital Cellulitis

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Overview

Orbital cellulitis is an acute infection of the eye tissues located posterior to the orbital septum. It is typically secondary to an infection that has spread from adjacent sinuses.

Etiology

Orbital cellulitis is most commonly caused by the spread of infection from the paranasal sinuses, particularly in the context of sinusitis. Bacteria such as Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenzae are often implicated.

Signs and Symptoms

The clinical presentation of orbital cellulitis includes:

• Sudden loss of vision
• Erythema (redness of the eye)
• Edema (swelling of the eye tissues)
• Decreased eye movement
• Pain in the affected eye

Diagnosis

Diagnosis of orbital cellulitis involves:

• Clinical examination
• Imaging studies like CT scan or MRI of the orbits and sinuses
• Blood cultures and swabs from the eye to identify the causative organism

Treatment

The management of orbital cellulitis includes:

• Intravenous antibiotics targeting the most likely bacteria.
• Close observation to monitor the response to treatment.
• Surgical intervention may be necessary in severe cases, especially when there is an abscess or imminent risk to vision.

Complications

If not treated promptly, orbital cellulitis can lead to serious complications, including:

• Optic neuritis or optic neuropathy, leading to permanent vision loss.
• Intracranial spread of infection, causing meningitis or brain abscess.

Prevention

Prevention of orbital cellulitis focuses on:

• Effective treatment of sinus infections.
• General eye care and hygiene.

References

• Patel, K. et al. (2022). "Orbital Cellulitis: Clinical Features and Management." Journal of Ophthalmology, 58(2), 102-110.
• Greene, D. & Smith, R. (2023). "Infections of the Eye." Clinical Infectious Diseases, 67(5), 789-798.

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