Ocular cellulitis - Infection of the eyelid and orbit
Cellulitis is an infection of the eyelid and orbit. Depending on the affected area, it is classified as superficial (preseptal) or deep (retroseptal or orbital). The deeper the infection, the more serious it is and the greater the risk of affecting other structures of the eye. Treatment for cellulitis is an ophthalmological emergency. Oral antibiotics must be prescribed promptly, and the infection must be monitored regularly. In cases of orbital involvement, hospitalization for intravenous treatment is usually necessary.
What is ocular cellulitis?
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Cellulitis is an infection of the soft tissues: skin, fat, muscles.
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In its ocular form, it can remain at the level of the eyelid (preseptal cellulitis) or enter the orbit (orbital or retroseptal cellulitis)
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This is a serious infectious ophthalmological emergency!
Diagnosis
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The diagnosis of preseptal or orbital cellulitis is clinical. The doctor observes swelling of the eyelid with redness and a sensation of heat.
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He will then look for signs of severity: decreased vision, impaired eye movement, fever, or altered consciousness.
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A triggering factor will also be sought: wound, sting, recent surgery, sinusitis, etc.
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In cases of orbital cellulitis or signs of severity, the doctor will order blood tests to look for inflammation and imaging of the orbit (CT scan or MRI) to assess the extent of the infection in the eyeball.
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In the event of an abscess, a needle sample of the pus may be taken for laboratory examination.
Causes
Cellulitis is caused by a bacterial infection and, more rarely, a fungal infection. Cellulitis is not usually spontaneous; a triggering factor may be identified, for example:
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An insect bite.
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An eyelid wound.
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Dental, head or neck surgery.
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A sinus infection
An infection can start in the sinuses and then spread to the eye socket or eyelid. These are considered serious forms of the infection.
Symptoms
Symptoms of cellulite can include:
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Swelling of the eyelid or tissues around the eye
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A red eyelid
Signs of severity
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The signs of severity are:
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A bulging eye
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Blurred or double vision
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Oculomotor disorders
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Fever
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Severe headaches or altered consciousness
Treatment
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Cellulite requires urgent antibiotic treatment.
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In cases of superficial infection, treatment can be administered orally at home. In cases of severe infection, hospitalization is necessary so that antibiotics can be given intravenously.
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In some situations, it may be necessary to drain an abscess. The collection of pus is aspirated with a needle.
Your doctor will explain the most suitable treatment for cellulite. If you have any questions, please don't hesitate to ask.
Prevention
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It is important to thoroughly clean any wound on the eyelid or face.
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In the case of sinusitis, it must be treated according to the recommendations. Leaving a sinus infection untreated risks allowing it to spread to the eye socket, and sometimes, even more seriously, to the brain.
Prognosis
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Superficial cellulitis, also known as preseptal cellulitis, generally has a good prognosis. However, if treatment is delayed, or if the orbit is involved, the infection can spread to the eye, brain, and along the neck, eventually becoming systemic.
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If you think you or your child has cellulitis, call a doctor immediately. If left untreated, cellulitis can lead to serious complications.