Orbital cellulite is a dangerous infection that could lead to serious complications. Orbital cellulites are an acute infection of the tissues surrounding the eye, including the eyelids, eyebrows, and plays. Orbital Cellulites most often presents with symptoms similar to preseptal cellulites such as red, swollen eyelids, but also includes pain, blurred or double vision, fever, headache and a red eye. Orbital cellulite is the most often caused by extension of the sinus infection from adjacent and especially the ethmoid sinuses (75 to 90%), it is less due to a direct infection or trauma accompanying spaces spread of infection from the face. Orbital cellulite is a medical emergency and requires clinical care. Treatment includes antibiotics given by a vein. Surgery may be needed to drain the abscess. Ampicillin / sulbactam treatment is a good choice. Corticosteroids may be useful. If the secondary glaucoma develops secondary to an orbital cellulitis, antihypertensives eye must be promptly initiated. In the case of post-orbital cellulitis, prophylaxis against tetanus should be paid according to the standard protocol. Proper detection and early treatment of sinus, dental, or other infections may prevent the spread of infection to the eyes. Bacteria from a sinus infection (often Haemophilus influenzae) usually cause this condition in children. Children up to age 6 - 7 seem to be particularly susceptible to infection with this type of bacteria. However, the rate of severe orbital cellulitis has dropped steadily since the introduction of HiB (Haemophilus influenzae B) vaccine. The patient with orbital cellulitis may be of any age or sex. There will be noticeable lid edema and redness, distention, proptosis, and significant pain upon palpation. Additionally, there will be diplopia from extraocular motility limitations. There typically will be a precipitating factor such as penetrating lid trauma, mucormycosis, orbital medial wall blow-out fracture, severe lid infectious disease, bite wounds, meningitis, sinusitis and sinus infection, septicemia, ketoacidosis, or dental abscess. Vision loss and an afferent pupil defect may often be present. The patient will also be systemically ill and have a fever. Orbital and periorbital cellulitis is usually caused by an infection of the sinuses near the nose. Insect bites or skin lesions that break the cause of about one third of these infections cellulite. Orbital periorbital cellulitis and can also occur in people with a history of dental infections. Orbital cellulitis is more common, both nationally and internationally, in the winter because of the increasing prevalence of sinusitis when the weather is cold. Orbital cellulite is more common in children than adults. Symptoms of Orbital Cellulites: - Swelling of the upper and lower eyelid. - Orbit becomes swollen and bulges. - Eye may appear red. - Decrease in the child's ability to move the eyeball. Orbital Cellulites Treatment and Prevention Tips 1. Corticosteroids may be helpful this condition. 2. Ocular antihypertensive should be instigated promptly 3. Rifampin should be given to the entire family for prevention. 4. If an Abscess develops, surgical drainage may be needed. 5. Antibiotics such as Nafcillin, Ampicillin, or Cefotaxime are given intravenously (IV). Persons at high risk for severe cellulitis will probably be hospitalized for treatment and monitoring. Antibiotics may be given intravenously to patients with severe cellulitis. Complications such as deep infection, or bone or joint infections, might require surgical drainage and a longer course of antibiotic treatment. Extensive tissue destruction may require plastic surgery to repair. In cases of orbital cellulitis caused by a sinus infection, surgery may be required to drain the sinuses.
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