eye disorders
Preseptal and Orbital Cellulitis
Key Points
Preseptal and orbital cellulitis are differentiated by whether infection is anterior or posterior to the orbital septum. Orbital cellulitis is usually caused by contiguous spread of ethmoid or frontal sinusitis, whereas preseptal cellulitis is commonly caused by contiguous spread from local facial or eyelid injuries, insect or animal bites, conjunctivitis, and chalazion. Both disorders can cause tenderness, swelling, warmth, redness or discoloration of the eyelid, and fever. Orbital cellulitis is likely if there is decreased ocular motility, pain with eye movements, proptosis, or decreased visual acuity. Antibiotic therapy is indicated, with surgery reserved for complicated orbital cellulitis (eg, abscess, foreign body, impaired vision, antibiotic failure). 