Periorbital Cellulitis: What You Need to Know

Medically Reviewed By Vicente Diaz, MD, MBA
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Periorbital cellulitis is an infection of the skin and tissue around the eye. The main causes are sinusitis and trauma to the area. Doctors will usually treat periorbital cellulitis with antibiotics. Periorbital cellulitis mainly affects children. It will usually resolve within 5–7 days after treatment with antibiotics.

Read on to learn more about the symptoms, treatment, and prevention methods for periorbital cellulitis.

What is periorbital cellulitis?

A child rubs their eye
Eddie Pearson/Stocksy United

Periorbital cellulitis, also known as preseptal cellulitis, is a bacterial infection that affects the area in front of the septum. The septum is a membrane separating the front of the orbit from the back of the orbit.

Periorbital cellulitis is similar to orbital cellulitis, which affects the eye itself and the structures behind the septum. Orbital cellulitis is a serious condition that can lead to blindness or death.

With proper treatment, periorbital cellulitis will not progress to orbital cellulitis and will clear up rapidly.

What causes periorbital cellulitis?

The most common causes of periorbital cellulitis include:

  • injury to the face or eye area
  • sinusitis, an infection causing inflammation of the sinuses
  • insect bites
  • impetigo, another skin infection common in children

Staphylococcus aureus and Streptococcus pyogenes are the most common bacterial causes of periorbital cellulitis.

What are the symptoms of periorbital cellulitis?

An eye showing signs of periorbital cellulitis
Periorbital cellulitis is an infection of the skin surrounding the eye. It presents with redness, swelling, and skin pain.
Mediscan/Alamy Stock Photo

Symptoms of periorbital cellulitis include:

  • redness
  • pain
  • swelling
  • tenderness

Your vision will not be affected, and it will not hurt to move your eye. Periorbital cellulitis does not typically cause fever.

Due to the similarities between the symptoms of periorbital cellulitis and orbital cellulitis, it is important to see your doctor to receive a proper diagnosis.

How do doctors diagnose periorbital cellulitis?

To diagnose periorbital cellulitis, your doctor will discuss your medical history with you and perform a visual examination. If your doctor cannot rule out orbital cellulitis, they will usually order a CT scan.

The CT scan will show:

  • the extent of swelling in the eyelid
  • whether there is any evidence of proptosis, or a condition where the eyeball bulges forward
  • whether the muscles around the eye are showing signs of infection
  • whether there has been a loss of fat around the eye

If your doctor still cannot definitively diagnose periorbital cellulitis, they will prescribe treatment as they would for orbital cellulitis to prevent any serious complications.

Periorbital cellulitis can also be commonly mistaken for:

What are the treatments for periorbital cellulitis?

While treatment can depend on age and the severity of the infection, the main treatment for periorbital cellulitis is antibiotics.

Your doctor may prescribe clindamycin with amoxicillin-clavulanic acid to kill the bacteria causing the infection. They may also prescribe cefpodoxime, another antibiotic medication.

Your doctor will usually prescribe an antibiotic course for 5–7 days. The infection typically clears up quickly and completely. If the infection does not clear up, your doctor may recommend you stay on the antibiotic course for longer.

If symptoms do not improve, hospitalization may be necessary for additional examination and treatment.

What are the potential complications for periorbital cellulitis?

Complications resulting from periorbital cellulitis are rare. The infection will not impair your vision or affect your ability to move your eye.

However, there can be serious complications if the infection becomes orbital cellulitis.

It is important to diagnose and treat periorbital cellulitis promptly to prevent the infection from moving to the back of the eye and causing orbital cellulitis.

How can you prevent periorbital cellulitis?

Prevention of periorbital cellulitis mainly involves avoiding or treating the underlying causes of the infection.

Use insect repellant when you are outside. Try to avoid injury to the facial area. If you have sinusitis or a skin infection, talk to your doctor to receive the proper treatment.

Summary

Periorbital cellulitis is an infection of the skin and tissue around the eye that mainly affects children. Sinusitis and trauma to the face or eye area are the main causes of the infection. Doctors will typically treat periorbital cellulitis with antibiotics.

Periorbital cellulitis does not typically cause serious complications. If the infection becomes orbital cellulitis, however, you may need to receive treatment in a hospital.

Talk to your doctor if the area around your eye is swollen or painful or if you have other symptoms that concern you.

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Medical Reviewer: Vicente Diaz, MD, MBA
Last Review Date: 2022 Apr 28
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