The CMGs offer information on the diagnosis and management of a range of conditions that present with varying frequency in primary and first contact care.
The CMGs offer information on the diagnosis and management of a range of conditions that present with varying frequency in primary and first contact care.
Preseptal and orbital cellulitis are infections of soft tissues that lie, respectively, anterior and posterior to the orbital septum. They occur most commonly in children under the age of 10.
Preseptal cellulitis is usually mild, except in young children. Orbital cellulitis can be sight and life-threatening. This Clinical Management Guideline outlines the aetiology, signs and symptoms and evidence-based recommendations for diagnosing both forms of the condition. It also outlines management and antibiotic treatment approaches for adults with preseptal cellulitis, and highlights the need for emergency referral in all other cases.
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What is preseptal and orbital cellulitis?
Cellulitis means inflammation of the soft tissues, often due to infection. Preseptal and orbital cellulitis are infections of the soft tissues in the socket that surrounds the eye, usually caused by common bacteria. They may follow a cold, sinusitis, an infection of the eyelid such as a stye, an infection of the tear drainage channels, or injury or recent surgery near the eye. It is important to try to distinguish between these two forms of cellulitis. Preseptal cellulitis is usually mild, except in young children, but orbital cellulitis can result in generalised infection which can be a life-threatening emergency.
How is preseptal and orbital cellulitis managed?
All cases of suspected orbital cellulitis need emergency (same day) referral to the ophthalmologist or to an accident and emergency department. Most will need to be admitted to hospital for tests and antibiotic treatment and a number of different specialists may be involved: ophthalmologists, ear, nose and throat specialists, and paediatricians (children’s doctors).
