Orbital Cellulitis

What is orbital cellulitis?

Orbital cellulitis is a bacterial infection of the skin, fat and muscles around your eyes. You might see it referred to as postseptal cellulitis. It’s similar to the cellulitis that can affect other parts of your body.

Orbital cellulitis can cause severe and long-term symptoms in your eye, including blindness. If you have symptoms like a high fever along with a bulging eye or swelling in or around your eye, go to the emergency room right away.

Who does orbital cellulitis affect?

Orbital cellulitis can affect anyone, but it’s most common in kids younger than 7.

Adults can get orbital cellulitis, but it’s rare. Orbital cellulitis in adults has the same causes and treatments.

Kids and adults who develop orbital cellulitis almost always (in more than 90% of cases) have a sinus infection that spreads to the tissue around their eye.

How common is orbital cellulitis?

Orbital cellulitis is rare. It’s more common for kids to develop periorbital cellulitis. However — because periorbital cellulitis can spread and become orbital cellulitis — it’s important to get any new symptoms in and around your child’s eyes examined by your provider right away.

How does orbital cellulitis affect my body?

Orbital cellulitis causes symptoms like swelling and discoloration or redness in and around your eye and eye socket. If it’s not treated quickly, the bacteria that cause orbital cellulitis can permanently damage your eye and cause blindness.

If the bacteria spread from your eye to other parts of your body, they can cause other serious issues, including:

• Optic nerve damage.
• Hearing loss.
• Meningitis.
• Blood infections.
• Retinal vein occlusion.

What are orbital cellulitis symptoms?

Orbital cellulitis symptoms include:

• Swelling of the eyelid and skin around your eye.
• Bulging eyes (proptosis).
• Discoloration or redness.
• Trouble seeing or double vision.
• Painful or difficult eye movement.

What causes orbital cellulitis?

Orbital cellulitis is caused by a bacterial infection. Lots of common bacteria cause orbital cellulitis. The most common ways bacteria get into the skin, fat and muscle around your eyes include:

• Sinus infections that spread.
• Infections in other parts of the face, mouth, tear ducts or ears that spread.
• Eye injuries or traumas to the area around your eye.

Is orbital cellulitis contagious?

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

How is orbital cellulitis diagnosed?

An eye care specialist will diagnose orbital cellulitis with a physical exam. They’ll ask you about your (or your child’s) symptoms. They’ll examine the affected eye and the area around it.

Tell your eye care specialist if you or your child has experienced any of the following:

• Recent injuries or damage to the eye and the skin around it.
• A newly diagnosed infection.
• New medications.

Which tests are done to diagnose orbital cellulitis?

There’s no test to confirm orbital cellulitis. However, your eye care specialist might order blood tests to rule out other infections or conditions.

Imaging tests like a CT scan or MRI can help your eye care specialist distinguish between orbital cellulitis and other types of infections.

How is orbital cellulitis treated?

Orbital cellulitis is treated with antibiotics. You’ll probably need to stay in the hospital and receive antibiotics through an IV (intravenously). If your symptoms get better after a few days, you should be able to go home and switch to oral antibiotics (pills taken by mouth).

Most people need to take antibiotics for a few weeks.

If the infection causes an abscess you’ll need surgery to drain it.

Complications/side effects of the treatment

Antibiotics side effects include:

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

How do I manage my orbital cellulitis symptoms?

The best way to feel better is to make sure you take the full course of your antibiotics. You need to take your medicine for as long as your eye care specialist prescribes it. This will make sure the antibiotics can successfully kill all the bacteria.

You might be tired from fighting the infection. Rest will help you recover and regain your strength.

How soon after treatment will I feel better?

You or your child should start to feel better in a few days after starting antibiotics.

However, antibiotics need time to kill all the bacteria that are making you or your child sick. Even if you or your child feels better, it’s important to take the antibiotics for as long as your provider instructs. There’s a chance of redeveloping cellulitis — or other infections — if the antibiotics aren’t taken for as long as directed.

How can I prevent orbital cellulitis?

You can prevent orbital cellulitis by treating infections as soon as possible. If you have an infection in your mouth or sinuses, visit a healthcare provider right away. Treating these less serious infections immediately can stop them from spreading to the tissue around your eye.

What can I expect if I have orbital cellulitis?

You or your child should expect to make a full recovery. Getting symptoms diagnosed right away is very important. The sooner you or your child starts antibiotics, the less likely it is there will be complications.

How long does orbital cellulitis last?

Orbital cellulitis usually lasts a week or two after you start antibiotics.

Will my child need to miss school?

Your child might need to miss school while they’re recovering from orbital cellulitis.

They aren’t contagious and can’t spread the bacteria that cause cellulitis, but they might need to stay in the hospital for a few days and could need rest and time to recover even after they’ve started treatment.

Talk to your provider about which activities your child should avoid while they’re on antibiotics.

What is the outlook for orbital cellulitis?

The outlook for orbital cellulitis is positive. The swelling and discoloration around your eye can be scary, but it’s treatable and should start to improve right away after you start taking antibiotics. The most important way to prevent complications is to get your symptoms diagnosed as soon as you notice them.

When should I see my healthcare provider?

Visit your healthcare provider as soon as you notice any symptoms or changes in your eyes. Orbital cellulitis can be very dangerous, and if it’s not treated right away, it can cause permanent damage to your eye and body.

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

When should I go to the ER?

Go to the emergency room if you experience any of the following:

• Vision loss.
• Double vision.
• Pain in or around your eye.
• Swelling, especially if it’s getting worse.

What questions should I ask my doctor?

• Do I have orbital cellulitis or another infection?
• Will I need to stay in the hospital? For how long?
• Will I need imaging tests?
• Which antibiotics will I need?
• How long do I need to take the antibiotics?

What’s the difference between orbital cellulitis and periorbital (preseptal) cellulitis?

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

Periorbital cellulitis is an infection in the skin around your eye or eyelid. You might see it referred to as preseptal cellulitis.

Orbital cellulitis is a bacterial infection of the skin, fat and muscle. Because it affects deeper tissues in your eyes, it can cause permanent vision issues.

What’s the difference between orbital cellulitis and pink eye (conjunctivitis)?

Orbital cellulitis and pink eye (conjunctivitis) are both infections that affect your eyes.

Orbital cellulitis is a bacterial infection of the tissue around your eye and eye socket. It causes inflammation and discoloration or redness outside and around the eye. It’s not contagious.

Pink eye is an infection in your conjunctiva, the clear tissue that lines the inside surface of your eyelid and outer coating of your eyeball. It can be caused by viruses, bacteria or allergic reactions. Pink eye caused by a virus is very contagious.

What’s the difference between orbital cellulitis and styes?

Styes are formed when a tiny oil gland near your eyelashes becomes blocked and gets infected.

Styes can be painful and are usually a single bump that you can see and feel.

Orbital cellulitis is caused by bacteria infecting the skin, fat and muscles around your eye. It causes swelling that’s not concentrated in a single spot. It usually affects your whole eye socket or a large area around it.

A note from Cleveland Clinic

Orbital cellulitis is a serious infection. Fortunately, it’s very treatable. Get your eyes examined as soon as possible. If you notice any changes in your eyes, visit an eye care specialist or go to the emergency room right away.