Chandler classification of orbital infections

Last revised by Dr Patrick J Rock on 12 May 2021

Chandler classification is the most commonly used system for dividing the different types of orbital cellulitis. The system describes five stages 1,2:

  • stage I: preseptal orbital cellulitis with inflammation and edema anterior to the orbital septum.
  • stage II: orbital cellulitis with extension of the inflammation and edema beyond the orbital septum. 
  • stage III: subperiosteal abscess beneath the periosteum of lamina papyracea.
  • stage IV: orbital abscess and purulent collection within orbit. 
  • stage V: cavernous sinus thrombosis after posterior extension of the infection through the superior ophthalmic veins.

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Cases and figures

  • Stage I: preseptal periorbital cellulitis
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  • Stage III : sub-periosteal abscess
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