What Is Orbital Cellulitis?

Orbital cellulitis, also known as cellulitis of the eye or postseptal cellulitis, is an infection that affects the tissues around the eye and the eye socket. Orbital cellulitis is a bacterial infection that affects the dermal layer of the skin and the soft tissues surrounding the eye. The eyelids, the eyebrow region and the cheek may be affected by this infection. This condition causes pain, redness and swelling and is potentially serious due to the location of the infection. Before the advent of antibiotic medications, postseptal cellulitis resulted in blindness in 20 percent of individuals that contracted the infection and death in another 17 percent of affected individuals. Therefore, this condition should be treated as a medical emergency and not ignored. Treatment of orbital cellulitis with antibiotic medications has significantly reduced the incidence of blindness and death due to this infection.

Symptoms and Signs

An individual with cellulitis of the eye may experience localized symptoms and systematic symptoms. Localized symptoms are the symptoms that occur at the location of the infection, such as pain in the affected eye, bulging of the affected eye, reduced movement of the affected eye, swelling of the eyelids and surface membranes of the eye, a red or purple appearance to the eyelids, decreased vision and double vision. Systemic symptoms of an infection include a mid-range or high fever, fatigue and discomfort. For more information, see the Cellulitis Symptoms page.

Causes of Orbital Cellulitis

Orbital cellulitis may be caused by various types of bacteria. Most cases of orbital cellulitis in adults are caused by bacteria in the genera Staphylococcus and Streptococcus. These bacteria are very common opportunistic disease-causing agents. A bacterium called Haemophilus influenzae type B (HiB) has historically been associated with many causes of orbital cellulitis in children, but a vaccine against HiB has been developed that has dramatically decreased the number of cases of HiB-caused orbital cellulitis. You can read more about the causes of cellulitis of the eye at the Cellulitis Causes page.

Risk Factors

Research indicates that there are certain factors that make a person more susceptible to developing orbital cellulitis. These risk factors for cellulitis of the eye include infections affecting the teeth, face or ear, trauma to the eye and sinus infections. Chronic infections are more likely to lead to orbital cellulitis than acute infections that are cleared up with antibiotic treatment. Approximately 3 percent of people with chronic sinusitis will develop orbital cellulitis, and almost three quarters of people with orbital cellulitis have a comorbid sinus infection. Risk factors for cellulitis are described in further detail at the Cellulitis Risk Factors page.

Diagnosing of Cellulitis of the Eye

Orbital cellulitis is usually diagnosed with a clinical examination of the eye, a thorough medical history of the patient and blood testing for the presence of an infection. In some cases, medical imaging may be used to see the extent of the infection and whether a sinus infection or an abscess is also present in addition to the orbital cellulitis. For more details about the diagnosis of orbital cellulitis, please visit the Cellulitis Diagnosis page.

Treatment for Orbital Cellulitis

It is extremely important to get medical attention for orbital cellulitis immediately; the sooner that cellulitis of the eye is treated, the more likely that complications of the condition will be avoided. The first step in the treatment of orbital cellulitis is a course of antibiotics. Intravenous antibiotics are usually given for orbital cellulitis in the hospital. More than one antibiotic medication may be used to clear up the infection. After treatment for several days with intravenous antibiotics, oral antibiotic medications may be given. It is important to let your doctor know about any drug allergies, such as an allergy to penicillin or sulfa drugs, before undergoing antibiotic treatment.

In some cases, surgical intervention is necessary for cases of orbital cellulitis that present with certain complications. Surgery may be an option if the antibiotic treatment is not working, if vision is endangered or if a person has a problem with abscess formation due to the infection.

Potential complications of cellulitis of the eye include permanent vision problems, including difficulty moving the affected eye, double vision and blindness. Cellulitis can also result in abscess formation and possibly the development of meningitis, a serious infection of the membranes around the brain and spinal cord. Meningitis is a life-threatening condition. Untreated infections also have a chance of spreading to the bloodstream and causing septic shock and infection of internal organs. However, the prognosis with prompt medical intervention is good. For more general information about treatment of cellulitis, see the page about Cellulitis Treatment.

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