eye disorders
Preseptal and Orbital Cellulitis
Symptoms and Signs of Preseptal and Orbital Cellulitis
Symptoms and signs ofpreseptal cellulitisinclude tenderness, swelling, warmth, redness or discoloration (violaceous in the case ofH. influenzae) of the eyelid, and sometimes fever. Patients may be unable to open their eyes because of eyelid swelling. The swelling and discomfort can make it difficult to examine the eye, but when accomplished, examination shows that visual acuity is not affected, ocular movement is intact, and the globe is not pushed forward (proptosis). Symptoms and signs oforbital cellulitisinclude swelling and redness of the eyelid and surrounding soft tissues, conjunctival hyperemia and chemosis, decreased ocular motility, pain with eye movements, decreased visual acuity, and proptosis caused by orbital swelling. Signs of the primary infection are also often present (eg, nasal discharge and bleeding with sinusitis, periodontal pain and swelling with abscess). Fever is usually present. Headache and lethargy should raise suspicion of associated meningitis. Some or all of these findings may be absent early in the course of the infection. Subperiosteal abscesses, if large enough, can contribute to symptoms of orbital cellulitis such as swelling and redness of the eyelid, decreased ocular motility, proptosis, and decreased visual acuity. 