Chandler classification of orbital infections

Last revised by Travis Fahrenhorst-Jones on 18 Nov 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

  • Figure 1: Chandler classification of orbital infections (diagram)
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  • Case 1: stage I - preseptal periorbital cellulitis
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  • Case 2: stage II - orbital and periorbital cellulitis
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  • Case 3: stage III - subperiosteal abscess
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  • Case 4: stage V - cavernous sinus thrombosis
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