Condition

Orbital cellulitis

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What it is

Orbital cellulitis is infection within the orbit, the bony space containing the eye and its muscles. It is much more serious than preseptal cellulitis, which affects only the eyelid in front of the eye's tough lining.

Warning symptoms

Seek emergency care if these develop.

  • Painful, swollen eyelid with fever and feeling unwell
  • Reduced or painful eye movement
  • Protruding eye or double vision
  • Child with a swollen eyelid after sinus infection or injury

Causes

It often spreads from a sinus infection, especially in children, or from trauma, surgery or a skin infection. Prompt treatment of sinus problems and eyelid infections reduces risk.

Treatment

Hospital admission and intravenous antibiotics are usually needed, with imaging to check for abscess. Delay can affect vision and spread infection. Mild eyelid redness without fever or eye movement problems may be a less serious infection, but assessment is important.

Frequently asked questions

What is the difference between orbital and preseptal cellulitis?

Preseptal cellulitis is a superficial eyelid infection, often without fever or eye movement problems. Orbital cellulitis is deeper, more serious, and can affect vision, needing emergency hospital care.

Is a swollen eyelid with fever an emergency?

Yes, especially if the eye is painful to move, vision changes, or the eye looks pushed forward. These features suggest orbital cellulitis and need urgent hospital assessment.

How is orbital cellulitis treated?

Treatment is usually hospital admission with intravenous antibiotics and scans to check for an abscess. Surgery is sometimes needed.

Your next step

Take this to your appointment

Write down what has changed, when it started, your current medicines and the questions you want answered. Take these to your eye-care appointment.

Sudden loss of sight, severe eye pain or a dark curtain across vision needs immediate assessment. Do not wait to complete a worksheet.

Sources for this information

These references support the information on this page. Follow the linked source for its full context.