Orbital cellulitis is an infection of the fat and muscles around the eye. It affects the eyelids, eyebrows, and cheeks. It may begin suddenly or be a result of an infection that gradually becomes worse.
Orbital cellulitis is a dangerous infection, which can cause lasting problems. Orbital cellulitis is different than periorbital cellulitis, which is an infection of the eyelid or skin around the eye.
In children, it often starts out as a sinus infection from bacteria such as Haemophilus influenza. The infection used to be more common in young children, under the age of 7. It is now rare due to a vaccine that helps prevent this infection.
The bacteria Staphylococcus aureus, Streptococcus pneumoniae, and beta-hemolytic streptococci may also cause orbital cellulitis.
Orbital cellulitis infections in children may get worse very quickly and can lead to visual difficulties or blindness. Medical care is needed right away.
Symptoms may include:
Tests commonly done include:
Other tests may include:
In most cases, a hospital stay is needed. Treatment most often includes antibiotics given through a vein. Surgery may be needed to drain the abscess or relieve pressure in the space around the eye.
An orbital cellulitis infection can get worse very quickly. A person with this condition must be checked every few hours.
With prompt treatment, the person can recover fully.
Complications may include:
Orbital cellulitis is a medical emergency that needs to be treated right away. Contact your health care provider if there are signs of eyelid swelling, especially with a fever.
Getting scheduled HiB vaccine shots will prevent the infection in most children. Young children who share a household with a person who has this infection may need to take antibiotics to avoid getting sick.
Prompt treatment of a sinus or dental infection may prevent it from spreading and becoming orbital cellulitis.
Bhatt A. Ocular infections. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 61.
Durand ML. Periocular infections. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 116.
McNab AA. Orbital infection and inflammation. In: Yanoff M, Duker JS, eds. Ophthalmology. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 12.14.
Olitsky SE, Marsh JD, Jackson MA. Orbital infections. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 652.BACK TO TOP
Review Date: 9/10/2022
Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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