What is Orbital Cellulitis: Causes, Symptoms, Treatment, Diagnosis

What is Orbital Cellulitis?

Orbital Cellulitis is a pathological ophthalmologic condition characterized by an infection of the soft tissues in the eye socket. Orbital Cellulitis if not treated can cause serious complications, including permanent blindness. This condition is at times also known by the name of postseptal cellulitis. There is no age prevalence seen in cases of Orbital Cellulitis but are mostly seen in young children. The source of the infection is the soft tissues that are present behind the orbital septum. It is a membrane that is present in front of the eyeball. The infection at times even spreads to involve the skin around the eyes as well.[1]

Some studies show that Orbital Cellulitis generally occurs during the winter season. This is because inflammation of the sinuses plays a crucial role in the development of this condition and this occurs normally in the winters. Studies also suggest that in the United States the cases of Orbital Cellulitis are on the rise due to the presence of methicillin resistant Staph Aureus infections.[1]

What is Orbital Cellulitis?

Additionally, it is the boys who get Orbital Cellulitis more than girls with the ratio being 2:1 in males in children. Maximum cases of Orbital Cellulitis are reported in children between 7 and 12 years of age.[1]

What Causes Orbital Cellulitis?

The primary cause of Orbital Cellulitis is inflammation of the sinuses, namely sinusitis. In fact, approximately 80% of the cases of Orbital Cellulitis are caused due to sinusitis. If it remains untreated, the inflammation and infection spreads to the eyes and causes infection of the soft tissues in the eye socket. In addition to sinus infections, bacterial infections due to Staph Aureus are also responsible for causing Orbital Cellulitis.[2]

In some cases, infections at other location in the eye can spread to the eye socket and cause Orbital Cellulitis. In rare instances, bacterial infections from other parts of the body spread through the blood to the eyes causing this condition. Some of the other causes of Orbital Cellulitis include.[2]

  • Injury or trauma to the eyes such as a penetrating injury
  • Complications arising out of surgical procedure to the eyes
  • Oral abscesses
  • Presence of a foreign object in the eye[2]

What are the Symptoms of Orbital Cellulitis?

Orbital Cellulitis is quite a serious infection. It may cause the eyes to move out of their socket. There will be severe pain along with swelling of the eyes. The movement of the eyes also becomes limited and any attempts at moving them will cause severe pain. The vision also becomes impaired and this tends to occur all of a sudden. In some cases, it becomes literally impossible to open up the eyes due to the infection.[2]

Discharge from the eye that is infected is also observed in some cases of Orbital Cellulitis. Additionally, there is fever, appetite loss, fatigue, and persistent headaches are seen with Orbital Cellulitis.[2]

How is Orbital Cellulitis Diagnosed?

Orbital Cellulitis is an emergent condition and it is important that condition be diagnosed as early as possible. For this, it is vital for an individual with even minimal symptoms of Orbital Cellulitis be checked thoroughly to rule in or rule out Orbital Cellulitis for prompt treatment.[2]

To begin with, a detailed physical examination will be conducted of the eye. The physician will check for the presence of infection in the eye socket like redness, pain, or swelling. Symptoms like fever are also indicators for an active infection and if supported by symptoms in the eye socket is a clear sign of Orbital Cellulitis. Additional tests will then be ordered to look at the extent and severity of the infection. If there is any discharge from the eye, then a culture of the discharge will be done to confirm the infection.[2]

In some cases, radiological studies will be conducted in the form of CT or an MRI scan to confirm the diagnosis of Orbital Cellulitis. These studies will also allow the physician to identify whether any complications have developed due to the infection or not.[2]

How is Orbital Cellulitis Treated?

As stated, Orbital Cellulitis is an emergent medical condition that requires immediate treatment. This is because this infection spreads quite rapidly and in no time complications start to develop. The primary treatment options for Orbital Cellulitis include:[2]

Antibiotics: Immediately after diagnosis, the physician will start the patient on a course of broad spectrum antibiotics to control the spread of the infection. This is normally done intravenously. These antibiotics are extremely effective in treating a wide variety of bacterial infections. The patient will have to be admitted to the hospital throughout the course of the antibiotics for co continuous monitoring and treating any complications if they do arise.[2]

Surgery: In some cases, a patient with Orbital Cellulitis will require surgery if antibiotic treatment is deemed to be ineffective in controlling and treating the condition, or if there are severe complications, or if the infection spreads to the parts of the head.[2]

Specifically, surgery will be recommended in cases where the patient has vision impairment or loss during antibiotic treatment. It is also recommended in cases where an abscess is observed in the brain or the eye socket. Physicians also recommend surgical intervention in cases where a foreign object is believed to be trapped in the eye.[2]

The procedures done for treatment of Orbital Cellulitis include drainage of abscess and removal of the foreign object. Sometimes a procedure is also done to take out tissues samples from the eye socket to look at the severity and extent of Orbital Cellulitis.[2]

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