Orbital infection
Updates to Article Attributes
Orbital infection can be a commonly encountered entity.
It is important to differentiate between orbital and periorbital cellulitis, as this has therapeutic and prognostic implications:
-
periorbital cellulitis (preseptal cellulitis) is limited to the soft tissues anterior to the orbital septum 1
- often managed with oral antibiotics
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orbital cellulitis (post-septal cellulitis) extends posterior to the orbital septum 1
- more serious condition requiring hospitalisation and parental antibiotics
- complications such as intraorbital abscess formation may require surgical intervention
Epidemiology
Orbital infections represent more than half of primary orbital disease processes 2. These infections typically present in children and yound adults but can affect any age group.
Clinical presentation
- proptosis
- painful ophthalmoplegia
- chemosis
- reduced visual acuity
Pathology
Aetiology
Periorbital cellulitis often results from contiguous spread of an infection of the face, teeth, or ocular adnexa. Orbital cellulitis typically results from extension of a paranasal sinusitis infection1.
Radiographic features
Urgent imaging is indicated to assess the anatomic extent of disease, including postseptal, cavernous sinus and intracranial involvement; evaluate for sources of contiguous spread, such as with sinusitis or trauma; and identify orbital abscesses that require exploration and drainage 3.
CT
Periorbital cellulitis
Diffuse soft-tissue thickening and areas of enhancement anterior to the orbital septum are seen onperiorbital cellulitis. It is very difficult to differentiate between preseptal oedema and periorbital cellulitis on CT 4.
Orbital cellulitis
- poor definition of orbital planes
- inflammatory stranding in the intraconal fat
- intraconal or extraconal soft tissue mass
- oedema of the extraocular muscles
- intra-orbital abscess
- subperiosteal abscess
MRI
Content to be added.
Differential diagnoses
Treatment and prognosis
Periorbital cellulitis is treated with oral antibiotic therapy. Orbital cellulitis is treated with intravenous antibiotic therapy. However, if a subperiosteal abscess is present, surgical drainage may be necessary 1.
Complications
Complications of orbital cellulitis include 1:
- superior ophthalmic vein thrombosis
- cavernous sinus thrombosis
- loss of vision
- meningitis
- intracranial abscess
See also
-</ul><h4>Epidemiology</h4><p>Orbital infections represent more than half of primary orbital disease processes <sup>2</sup>.</p><h4>Clinical presentation</h4><ul>- +</ul><h4>Epidemiology</h4><p>Orbital infections represent more than half of primary orbital disease processes <sup>2</sup>. These infections typically present in children and yound adults but can affect any age group.</p><h4>Clinical presentation</h4><ul>
-</ul><h5>MRI</h5><p><em>Content to be added.</em></p><h4>Treatment and prognosis</h4><p><strong>Periorbital cellulitis </strong>is treated with oral antibiotic therapy. <strong>Orbital cellulitis</strong> is treated with intravenous antibiotic therapy. However, if a subperiosteal abscess is present, surgical drainage may be necessary <sup>1</sup>.</p><h5>Complications</h5><p>Complications of orbital cellulitis include <sup>1</sup>:</p><ul>-<li>superior ophthalmic vein thrombosis</li>- +</ul><h5>MRI</h5><p><em>Content to be added.</em></p><h4>Differential diagnoses</h4><ul>
- +<li><a href="/articles/orbital-pseudotumour">orbital pseudotumour</a></li>
- +<li><a href="/articles/lymphoma-of-the-orbit">orbital lypmhoma</a></li>
- +</ul><h4>Treatment and prognosis</h4><p><strong>Periorbital cellulitis </strong>is treated with oral antibiotic therapy. <strong>Orbital cellulitis</strong> is treated with intravenous antibiotic therapy. However, if a subperiosteal abscess is present, surgical drainage may be necessary <sup>1</sup>.</p><h5>Complications</h5><p>Complications of orbital cellulitis include <sup>1</sup>:</p><ul>
- +<li><a title="superior ophthalmic vein" href="/articles/superior-ophthalmic-vein">superior ophthalmic vein thrombosis</a></li>
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