What Is Periorbital Cellulitis?
Periorbital cellulitis is also known as preseptal cellulitis. It is an infection of your eyelid or the skin around your eyes. Adults can get it, but children under 2 years are most likely to have it. It usually happens when bacteria attack the soft tissue around your eye along with your eyelid.
Those germs can get into your skin through a cut, or they can get to the area through an infection in your sinuses. It can also be a reaction to a stye which means a tender bump on your eyelid that forms when a gland on your eyelid gets infected. Patients who have orbital cellulitis present with similar findings plus ocular symptoms such as proptosis, eye pain, decreased vision.
- Redness and swelling around your eye.
- A cut, scratch near the eye.
- The skin in the affected area is tender when touching.
- The white part of the eye looks red.
Periorbital cellulitis does not cause a fever. If you or your child has a fever and swelling it hurts to move the affected eye therefore, get medical help right away. These things can be caused by a serious condition which is called orbital cellulitis that affects the eye itself.
Most conditions of periorbital cellulitis resolve after five to seven days with the help of proper antibiotics. The treatment of periorbital cellulitis based on the severity of the disease condition and age of the patient, so when noticed visit your optometrist for proper treatment.
Your doctor will examine your eye to look see if a stye or injury is present or not. Your doctor may also examine your vision and their reaction toward the light. They will also take your health history in order to evaluate your likelihood of developing the chance of periorbital cellulitis.
Individuals who have had a methicillin-resistant staphylococcus aureus infection are more likely to develop periorbital cellulitis. Blood samples may be taken in order to determine the type of bacteria that causes periorbital cellulitis. X-ray or CT scans can also be conducted in order to have a closer look at the eye and its surrounding tissues in order to determine the cause of periorbital cellulitis.
Treatment / Management
The treatment of periorbital cellulitis based on the severity of the disease and also the age of the person. The main treatment is usually antibiotic coverage against S. aureus, Streptococcus species. Patients who are above one year of age with mild type of symptoms can be treated as an outpatient by using oral antibiotics. Those with more severe diseases or below one year of age should be admitted to the hospital.
Prior treatment of periorbital cellulitis included cefpodoxime or cefdinir. However, this is no prolong recommended due to the rise of MRSA. For MRSA coverage, it is recommended that the patient receive clindamycin, doxycycline. However, doxycycline does not cover group A streptococcus and is not recommended for children who are below the age of eight years. The current recommendation is clindamycin plus amoxicillin-clavulanic acid or cefdinir. If the patient is unimmunized by H. influenzae, antibiotic coverage with a beta-lactam is recommended. The antibiotic course is for five to seven days or longer if the cellulitis persists.
Response to the antibiotics is usually fast and complete. If the outpatient therapy fails to show improvement after 24 to 48 hours, the patient should be hospitalized with broad-spectrum antibiotics, CT scan, and surgical consultation should be considered for possible incision and drainage. No studies have shown that an association between steroids and the recurrence or complication of orbital cellulitis and thus steroids are not routinely prescribed.
As surgery is required for drainage. Also, if a clinician is unsure if the patient has periorbital or orbital cellulitis even without a CT scan, it is recommended to treat it as orbital cellulitis.
Periorbital cellulitis can be prevented through several methods that include practicing personal hygiene which is necessary in order to prevent cellulitis. This includes keeping toenails and fingernails neat and clean, keeping wounds and bug bites clean as well as moisturizing the skin in order to protect against cuts and cracks. There is also a vaccination that may prevent the development of cellulitis in which the vaccine is Hib and is able to protect individuals against certain strains of cellulitis. The Hib vaccine is provided to children routinely as a vaccination.