Formula Medical Group
Apple Valley, CA
760-242-1234


James Krider, MD


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Eye-socket inflammation - Orbital cellulitis

What is eye-socket inflammation?

This is an inflammation that affects the cavity in the skull called the eye socket or orbit, which contains the eyeball and other structures of the eye. It can develop at any age, but is most common in children. In some cases it is associated with meningitis.

Inflammation of the eyelid and tissue lining the eye socket, referred to as orbital cellulitis, is a serious but relatively rare disorder. Inflammation that affects the eyelid and surrounding skin, which is known in medical literature as periorbital cellulitis, tends to occur in children under the age of 5. It is not as serious as orbital cellulitis, but is much more common.

Swelling and redness of the eyelids and eye pain are usually the first signs of eye-socket inflammation. In most cases, only one eye is

SYMPTOMS

  • Swelling and redness of eyelids and possibly the conjunctiva.
  • Pain in the eye.
  • Restriction of eye movements.
  • Marked swelling and protrusion of the eyeball.
  • Fever, particularly in young children.
  • Nasal discharge.
  • Loss of vision.

affected. Children usually develop a fever, and some have a nasal discharge and conjunctivitis — an inflammation of the transparent membrane lining the eyeball. The eyeball may be swollen or protruding, and it may be impossible or difficult to move the eye.

What causes eye-socket inflammation?

The most common cause is spread of a sinus infection to the eye and surrounding tissues. Inflammation can also result from an external source of infection, such as a wound or an insect bite. The eye socket can become inflamed as a result of an eye injury, especially if it entailed penetration of the tissues lining the socket.

How is eye-socket inflammation diagnosed and treated?

Diagnosis begins with a careful eye examination that includes a vision test and evaluation of the eye movements. If the lids are swollen, they may be held apart with a special lid retractor that allows the doctor to inspect the eyeball. The face surrounding the eye and the sinuses will be

Orbital cellulitis, which is most common in children, usually affects only one eye.

Orbital cellulitis, which is most common in children, usually affects only one eye.

checked for infection. If the eyeball is protruding, its position may indicate the location of the underlying infection.

Blood tests and a culture may be ordered, but if the infection has not spread beyond the eye, the blood culture is often negative. A sinus x-ray may be done in children over the age of 1 year. If orbital cellulitis is suspected, a computed tomography (CT) scan may be helpful in evaluating the condition of the sinuses and checking for the presence of an abscess.

Patients with orbital cellulitis, particularly children, are usually hospitalized to ensure prompt and effective treatment. Therapy generally consists of intravenous antibiotics. A small sample of tissue or pus from the inflamed eye-socket tissue may be aspirated with a hollow needle and then cultured to determine the infectious agent. This enables a doctor to select the most effective antibiotic.

In babies under 12 months of age, a lumbar puncture may be performed. In this test, a specimen of cerebrospinal fluid is withdrawn from the space surrounding the spinal cord. In babies, the inflammation sometimes spreads to the lining of the brain or spinal cord, resulting in meningitis, which should be treated aggressively with antibiotics. If an abscess has formed in the eye socket, surgical drainage is needed.

What can I do myself?

Keep the area of the eye clean to prevent repeated infection.

When should I see my doctor?
See a doctor as soon as possible if symptoms of eye-

socket inflammation develop. Early diagnosis and treatment are essential to prevent spread of the infection and other complications.

What will the doctor do?
Conjunctivitis and other conditions that may produce signs and symptoms similar to eye-socket inflammation should be ruled out. If eye-socket inflammation is suspected, you should be referred to an eye specialist (ophthalmologist) for appropriate tests and treatment.

The course of eye-socket inflammation

Antibiotics usually cure the inflammation completely, and if treatment is given promptly, there should not be any complications. If treatment is delayed or complications develop, vision in the affected eye may be threatened.

Is eye-socket inflammation dangerous?
If left untreated, it can have serious complications. Long-standing inflammation of the eye socket can damage the blood vessels in the retina and injure the optical nerve. Impaired vision or even blindness may result. In severe cases, the inflammation can lead to formation of an abscess or spread to the sinuses or the brain, causing bacterial meningitis.

What can I do to avoid eye-socket inflammation?

  • Make sure that sinus infections are treated promptly.
  • Seek prompt treatment for any head or eye injury, especially if the skin has been broken.
This article was last reviewed November 27, 2005 by Dr. James Krider.
Reproduced in part with permission of Home Health Handbook.
Eye injury
Insect bite
Sinus infection


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