Periorbital Cellulitis

What is periorbital cellulitis?

Periorbital cellulitis is a bacterial infection of your eyelid or the skin around your eyes. It affects kids more commonly than adults. You might see it referred to as preseptal cellulitis. It’s similar to cellulitis that can affect other parts of your body.

It’s very rare for periorbital cellulitis to cause severe or long-term symptoms. Most people recover in about a week after starting antibiotic treatments.

Periorbital cellulitis vs. orbital cellulitis

Orbital cellulitis is more rare and dangerous than periorbital cellulitis. They’re both caused by a bacterial infection around the eye. The difference between them is which part of the eye is affected.

Orbital cellulitis is a bacterial infection of the fat and muscle. Because it affects deeper tissues in the eyes, it is more dangerous and can cause permanent vision issues. Periorbital cellulitis is much more common and far less dangerous.

Periorbital cellulitis vs. pink eye

Periorbital cellulitis and pink eye (conjunctivitis) are both infections that can affect both adults and children.

Periorbital cellulitis is a bacterial infection of the skin around your eye including your eyelid. It causes inflammation and discoloration outside and around the eye. It is not contagious.

Pink eye is inflammation of the conjunctiva, the clear tissue that lines the inside surface of your eyelid and the outer coating of your eye. It can be caused by anything from viruses to blocked tear ducts. Pink eye caused by bacteria or a virus can be very contagious.

Periorbital cellulitis vs. styes

Periorbital cellulitis is caused by bacteria getting under the skin. Styes form when a tiny oil gland near the eyelashes becomes blocked and gets infected.

A stye is painful and is usually a single bump that you can see or feel. Periorbital cellulitis is swelling that’s not concentrated in a single spot. It usually affects the whole eyelid or a large area around it.

No matter which condition you or your child have, see your provider right away if you notice swelling or discoloration in or around the eyes.

Who does periorbital cellulitis affect?

Periorbital cellulitis can affect anyone, but it’s most common in kids younger than age 5.

Adults can get periorbital cellulitis, it’s just not as common. Periorbital cellulitis in adults is caused in the same way and is treated exactly the same as it is in children.

How common is periorbital cellulitis?

Periorbital cellulitis is common, especially in children.

How does periorbital cellulitis affect my child’s body?

Periorbital cellulitis causes symptoms like swelling and discoloration around your child’s eye. It doesn’t affect their vision. It also isn’t painful.

What are periorbital cellulitis symptoms?

Periorbital cellulitis symptoms include:

• Swelling of the eyelid and skin around your or your child’s eye.
• Discoloration or redness.

Periorbital cellulitis doesn’t cause:

• Vision issues.
• Eye pain.
• Itching.
• Headaches.

If your or your child’s eye hurts, itches or vision is blurry, there may be a different problem going on, including orbital cellulitis.

Your healthcare provider will diagnose what’s causing the symptoms. If you notice new symptoms see your provider right away.

What causes periorbital cellulitis?

Periorbital cellulitis is caused by a bacterial infection. Lots of common bacteria cause periorbital cellulitis. The most common ways bacteria get into kids’ skin include:

• Scratches.
• Bug bites.
• Sinus infections that spread.
• Injuries or traumas to the area around the eye.

Is periorbital cellulitis contagious?

Periorbital cellulitis isn’t contagious. This means it’s not possible to pass it from person to person.

Even if your child has it in one of their eyes, periorbital cellulitis can’t spread from one eye to the other.

How is periorbital cellulitis diagnosed?

Your healthcare provider will diagnose periorbital cellulitis with a physical exam. They will examine your or your child’s eye and the area around it.

Make sure to tell your provider if you or your child have experienced any of the following:

• Recent injuries or damage to their eye and the skin around it.
• A newly diagnosed disease.
• Started new medications.

What tests are done to diagnose periorbital cellulitis?

There is no test to confirm periorbital cellulitis. However, your provider might order blood tests to rule out other infections or conditions.

Imaging tests like a CT scan or MRI can help your provider distinguish between periorbital cellulitis and orbital cellulitis.

How is periorbital cellulitis treated?

Periorbital cellulitis is treated with antibiotics. Antibiotics can be given in a few ways, depending on how severe the symptoms are, including:

• Oral pills or liquid.
• IV (intravenously).

Most children will need to take antibiotics for around a week.

Complications/side effects of the treatment

Antibiotics side effects include:

• Allergic reactions.
• Gastrointestinal symptoms like an upset stomach or diarrhea.
• Antibiotic resistance infections in the future.

How do I manage periorbital cellulitis symptoms?

The best way to help you or your child feel better is to make sure they take the full course of antibiotics. You or your child need to take the medicine for as long as your healthcare provider prescribes it. This will make sure the antibiotics can successfully kill all the bacteria causing the problem.

Your child might be tired from fighting the infection. Rest will help them recover and regain their strength.

How soon after treatment will I or my child feel better?

People should start to feel better one or two days after starting antibiotics.

However, antibiotics need time to kill all the bacteria that are causing the illness. Even if you or your child feel better, they need to take antibiotics for as long as your provider instructs. There’s a chance they’ll re-develop cellulitis or other infections if they don’t take antibiotics for as long as your provider prescribes.

How can I prevent periorbital cellulitis?

You can prevent periorbital cellulitis by keeping your child’s skin healthy. This includes:

• Treating cuts and scrapes right away: Wash cuts, scrapes and bug bites with warm water and soap.
• Keep skin clean: Teach your child good hygiene habits. Keeping their face clean and washing away bacteria on their skin that can cause infections.

What can I expect if my child has periorbital cellulitis?

You should expect your child to make a full recovery. Kids and adults with periorbital cellulitis almost always recover soon after starting antibiotics and rarely have complications.

How long does periorbital cellulitis last?

Periorbital cellulitis usually lasts around a week after starting antibiotics.

Will my child need to miss school?

Your child shouldn’t need to miss school while they’re recovering from periorbital cellulitis. They aren’t contagious and can’t spread the bacteria that cause cellulitis.

Talk to your provider about which activities — if any — you or your child should avoid while taking antibiotics.

What is the outlook for periorbital cellulitis?

The outlook for periorbital cellulitis is extremely positive. The swelling and discoloration around the eye can be scary, but it’s treatable and should start to improve right away after starting antibiotics.

When should I see my healthcare provider?

Talk to your healthcare provider as soon as you notice any symptoms or changes in or around the eyes. Periorbital cellulitis itself isn’t very dangerous, but if it’s not treated right away it can lead to more serious conditions like orbital cellulitis.

See your provider right away if symptoms don’t improve in a day or two after they start antibiotics.

When should I go to the ER?

Go to the emergency room if your child experiences any of the following:

• Vision loss.
• Pain in or around the eye.
• Bleeding.
• Swelling, especially if it’s getting worse.

What questions should I ask my doctor?

• Does my child have periorbital cellulitis or another infection?
• Will they need imaging tests to rule out orbital cellulitis?
• Which antibiotics will they need?
• How long does my child need to take the antibiotics?

A note from Cleveland Clinic

Anything that affects your or your child’s eyes is scary, but periorbital cellulitis is very common and will go away quickly after starting antibiotics. Make sure to talk to your healthcare provider as soon as you notice any symptoms. The sooner it is diagnosed, the faster you or your child will feel better.