Periorbital and orbital cellulitis

• What is cellulitis?


  Infection of the dermis and subcutaneous tissue
• What pathogen tends to cause cellulitis?


  Staphlococcus aureus

  Streptococcus pyogenes
• What area is affected in peri-orbital cellulitis?


  Skin and soft tissue anterior to the orbital septum
• What area is affected in orbital cellulitis?


  Soft tissue posterior to the orbital septum
• What are some risk factors for both peri-oribital and orbital cellulitis?

  Peri-orbital: Superficial injury

  Orbital: Spread of infection from paranasal sinuses or pre-existing peri-orbital cellulitis

  Both: Eye, ear or dental infection, URTI, sinusitis, trauma
• Does peri-orbital cellulitis have proptosis?


  No
• Does orbital cellulitis have proptosis?


  Yes
• What are eye movements like in periorbital cellulitis?


  Normal
• What are eye movements like in orbital cellulitis?


  Painful and restricted
• What is visual acuity like in periorbital cellulitis?


  Normal
• What is visual acuity like in orbital cellulitis?


  May be reduced
• What is colour vision like in periorbital cellulitis?


  Normal
• What is colour vision like in orbital cellulitis?


  May be reduced
• Is RAPD present in peri-orbital cellulitis?


  No
• Is RAPD present in orbital cellulitis?


  Yes - in severe cases
• How is peri-orbital cellulitis managed?


  Mild: >1 yrs oral co-amoxiclav or clarithromycin

  Severe or <1 yrs: IV antibiotics for 48 hrs then switch to oral
• How is peri-orbital cellulitis diagnosed?


  Clinically

  Imaging to rule ou orbital cellulitis
• How is orbital cellulitis investigated?

  FBC

  CRP

  Lactate

  Blood cultures

  CT
• How is orbital cellulitis managed?


  IV antibiotcs - co-amoxiclav

  Surgery - pus drainage

  Supportive care
• What is the diagnosis for this?

  Peri-orbital cellulitis

  
• What is the diagnosis for this?

  Orbital cellulitis