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Orbital Cellulitis

Sight-threatening and life-threatening infection of orbital tissues posterior to the orbital septum requiring urgent IV antibiotics and possible surgical drainage.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Göz Hastalıkları department. Book Appointment →

What is Orbital Cellulitis?

Orbital cellulitis is infection of orbital structures posterior to the orbital septum involving orbital fat, extraocular muscles, and surrounding connective tissue, distinguishing it from preseptal cellulitis confined to eyelid tissues.

Most cases (60-80%) result from contiguous spread from paranasal sinusitis, particularly ethmoid sinusitis through the thin lamina papyracea; other sources include dacryocystitis, dental infections, facial trauma, and post-surgical infections.

Classified by Chandler stages — preseptal cellulitis, orbital cellulitis without abscess, subperiosteal abscess, orbital abscess, and cavernous sinus thrombosis; complications include vision loss, intracranial extension, cavernous sinus thrombosis, and death without prompt treatment.

Symptoms

Proptosis (forward eye displacement)
Painful and limited extraocular movements (ophthalmoplegia)
Eyelid swelling, redness, and warmth
Vision changes and color desaturation
Conjunctival chemosis and hyperemia
Fever and systemic toxicity
Headache and altered mental status with intracranial spread

Risk Factors

Acute bacterial sinusitis particularly ethmoid sinusitis
Dental infections and periodontal abscess
Orbital trauma and foreign body
Recent orbital or sinus surgery
Dacryocystitis and severe conjunctivitis
Immunocompromise and uncontrolled diabetes
Pediatric age (more common 7-12 years)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • EMERGENCY — proptosis with eyelid swelling and pain
  • Painful eye movements with restriction
  • Vision loss or color desaturation
  • Fever with periorbital infection
  • Failed outpatient treatment of preseptal cellulitis
  • Suspected sinusitis with eye involvement
  • Altered mental status or severe headache

Treatment Methods

01
Immediate hospitalization with IV broad-spectrum antibiotics (vancomycin + ceftriaxone + metronidazole)
02
Urgent CT imaging of orbits and sinuses with contrast
03
Ophthalmology and ENT consultation
04
Surgical drainage of subperiosteal or orbital abscess via endoscopic or external approach
05
Drainage of underlying sinusitis (FESS) if surgical intervention
06
Hourly visual acuity, pupil, and color vision monitoring
07
MRI and venogram if cavernous sinus thrombosis suspected

Which Department to Visit?

You can visit our Göz Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Göz Hastalıkları Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.