Orbital Cellulitis

Orbital Cellulitis is a severe infection that affects the soft tissues posterior to the orbital septum, can potentially lead to serious complications if not treated promptly. It is a medical emergency and typically requires urgent care. For medical advice or diagnosis, consult a professional.

Causes:

Orbital cellulitis usually occurs due to the following causes:

1. Sinus Infections: The most common cause, particularly ethmoid sinusitis (inflammation of the sinuses near the nose).
2. Trauma or Surgery: Any trauma or surgical procedure around the eyes can introduce bacteria into the orbital tissues.
3. Dental Infections: Infections in the upper teeth or gums can spread to the orbit.
4. Spread from other infections: In rare cases, infections from other parts of the body can spread to the orbit.
5. Hematogenous spread: Infections from distant sites of the body can spread through the bloodstream, though this is rare.

The most common bacteria causing orbital cellulitis are:

• Streptococcus pneumoniae
• Staphylococcus aureus, including methicillin-resistant Staphylococcus aureus (MRSA)
• Haemophilus influenzae (especially in children)
• Anaerobes (from dental infections)

Signs:

1.Redness and swelling of the eyelids
2.Proptosis (bulging of the eye)
3.Swelling of the conjunctiva (redness in the eye)
4.Tenderness around the eye or the orbital region

Symptoms :
1.Pain around or behind the eye, often worsened with eye movement
2.Limited eye movement (painful or restricted)
3.Photophobia (increased sensitivity to light)
4.Fever and general malaise
5.Headache
6.Vision changes (blurry vision, double vision, or loss of vision)

Diagnosis:

1. Clinical evaluation: Symptoms like eye pain, swelling, fever, proptosis, and restricted eye movement.
2. Imaging: CT scan or MRI to assess the extent and rule out abscess or complications.
3. Lab tests: Blood cultures, complete blood count (CBC) showing elevated white blood cells.
4. Differential diagnosis: Rule out periorbital cellulitis and other conditions mimicking the symptoms.

Treatment:

1. Intravenous (IV) antibiotics: Broad-spectrum antibiotics are given to cover both aerobic and anaerobic bacteria. Common choices include:
   • Ceftriaxone or cefotaxime (for general coverage)
   • Vancomycin (for MRSA coverage)
   • Metronidazole (for anaerobes)
2. Surgical drainage: If an abscess is present and not improving with antibiotics, drainage may be needed.
3. Hospitalization: Most patients require admission for IV antibiotics, monitoring, and supportive care.

Treatment should begin promptly to prevent complications like vision loss or spread to the brain.

Complications:

If left untreated, orbital cellulitis can lead to serious complications, including:

1. Blindness: Due to optic nerve damage or spread of infection to the eye.
2. Abscess formation: Pus-filled pockets can form in the orbit, leading to increased pressure.
3. Meningitis: Infection can spread to the meninges (the membranes around the brain).
4. Cavernous sinus thrombosis: A life-threatening clot in the large veins at the base of the brain.
5. Sepsis: A systemic infection that can lead to organ failure and death.

Prognosis:

The prognosis for orbital cellulitis is generally good, especially if treated early. However, if the condition recurs or is associated with a systemic disease, long-term management may be necessary.

If you experience any symptoms of cellulitis, it’s important to see an eye specialist (ophthalmologist) promptly for diagnosis and treatment.