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)