ORBITAL CELLULITIS

Orbital cellulitis is a sudden acute inflammation of the tissues around the eye.

Causes

  • Children- most common cause is post sinus infection by Haemophilus influenza
  • Adults- common causes are Staphylococcus aureus, Streptococcus pneumonia and beta-haemolytic
    streptococcus
  • Risk factors
  • Sinus infection, tooth extraction, orbital trauma

Clinical features

  • Painful swelling of the eye
  • Pain in the eye especially on eye movements
  • Decreased vision
  • Fever and headache

Differential diagnosis

  • Infection – Cavernous sinus thrombosis
  • Endocrine dysfunction – Dysthyroid exophthalmos
  • Idiopathic inflammation – Orbital myositis, orbital pseudotumour, Wegener’s granulomatosis
  • Neoplasm with inflammation, e.g. Burkitt’s lymphoma

Investigations

  • Good history taking and examination

MANAGEMENT

  • This is an emergency and needs immediate referral to the ophthalmologist

Prevention

  • Prompt treatment of sinus and dental infections
  • Complete immunization schedule for children, more especially Hib vaccine (included in the pentavalent DPT/
    HepB/Hib vaccine)