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Orbital cellulitis is an uncommon, but severe infection of the muscles and fat behind the eyeball. It does not affect the eyeball.
Orbital cellulitis is an emergency condition that needs fast treatment to prevent serious complications, such as sight loss and meningitis.
It can sometimes be confused with a less severe, but more common condition called periorbital (preseptal) cellulitis. This is because both conditions can cause eye pain, and eyelid swelling and redness.
If you suspect you have orbital cellulitis see a doctor or go to the nearest hospital immediately.
Periorbital cellulitis is an infection of the eyelid and the skin surrounding the eye.
However, unlike orbital cellulitis, periorbital cellulitis does not affect the fat and muscles in the eye socket.
While orbital and periorbital cellulitis are different conditions, they can have similar symptoms.
Both can affect how your eye looks and feels. And both conditions tend to affect 1 eye, although they can sometimes affect both eyes.
The symptoms of orbital cellulitis include:
Some people with orbital cellulitis may also develop a fever or feel more tired than normal.
Periorbital symptoms include:
A bacterial sinus infection is the most common cause of orbital cellulitis, but other causes include:
While a sinus infection is the most common cause of orbital cellulitis, preseptal cellulitis tends to be caused by external factors such as:
Orbital cellulitis is an emergency condition that can cause sight loss if it is not treated promptly. See a doctor or go to hospital immediately if you think you may have orbital cellulitis.
Your doctor may suspect orbital or periorbital cellulitis based on your symptoms, medical history and an examination of your face and eyes.
Your doctor will usually diagnose periorbital cellulitis without tests. But if they are unsure if you have periorbital or orbital cellulitis, you may be given some tests, including:
If your doctor suspects orbital cellulitis, you will most likely be referred to an eye specialist (ophthalmologist) and/or ear, nose and throat (ENT) specialist for treatment.
Orbital cellulitis is usually treated in hospital with antibiotics, which are given through a vein in the arm (IV).
It’s common to stay in hospital for 7 to 10 days while having antibiotics.
Treatment for orbital cellulitis may also involve:
Periorbital cellulitis is treated with antibiotics, usually taken by mouth.
In some cases, you may need to be admitted to hospital for IV antibiotics. This includes if you:
The most common complication of preseptal cellulitis is orbital cellulitis. This is more likely in young children.
Preseptal cellulitis rarely comes back, but when it does, it is usually due to an underlying cause that was not diagnosed.
Orbital cellulitis can lead to an abscess. This may develop in the eye socket (orbital abscess) or in the wall of the eye socket (subperiosteal abscess).
Other, less common, complications of orbital cellulitis include:
Most people recover from orbital and preseptal cellulitis with antibiotic treatment and symptoms typically begin to improve 24 to 48 hours after starting this treatment.
You will need to stay in hospital while receiving treatment for orbital cellulitis. This can last from 1 to 3 weeks. After this time you should be able to return to work, but speak to your doctor to confirm that you are well enough to go back.
If you had preseptal cellulitis that was treated with oral antibiotics as an outpatient, you will usually be able to go back to work sooner.
It can take much longer to recover from orbital cellulitis if you develop complications.
To find answers to any other health questions you might have, visit our Health A-Z.
Date of last review: 1 July 2020
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Preseptal and Orbital Cellulitis - Eye Disorders - MSD Manual Professional Edition [Internet]. MSD Manual Professional Edition. 2020 [cited 6 March 2020]. Available here.
Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.