Periorbital cellulitis

 

Periorbital cellulite should be considered a very serious infection of the eyelid and the tissues and structures around it, which can be very complicated if not diagnosed and treated in time. If you want to know more about periorbital cellulite, be sure to read more, in this article, we will get you familiar with the causes of periorbital cellulitis, its symptoms, diagnosis and treatment of periorbital cellulite.

 

Periorbital cellulite

What causes periorbital cellulite?

Symptoms of orbital cellulitis

Diagnosis

treatment

Complications of periorbital cellulite

How to prevent periorbital cellulite?

 

 

Periorbital cellulite

Pretibial means around the eye. Cellulite is an inflammation and infection of the tissues and structures around the eye that develops in five stages:

 

The first stage of peritoneal cellulite:

  • There is swelling of the eyes and eyelids
  • General lethargy can be present
  • Fever may be present

 

The second stage of peritoneal cellulite:

Eye infection and inflammation of the tissues around the eye with edema

Swelling of the eyelids and tissues around the eyelids

Congestion

Sometimes droopy eyelids and problems moving the eyeball left and right and up and down

Sometimes vision problems.

 

Stage three Periorbital cellulite:

An abscess forms under the septum of the eyeball. A moving mass forms under the septum of the eyeball, and as the size of the abscess increases, the eyeball shifts from its original location. The eye and the surrounding tissue become locally sensitive

The veins and the area around the eye become constricted and bloody. This hyperemia will be seen by the doctor in the examination of the device in the arteries of the lower eye (the retinal arteries)

There is severe eye pain and the pressure inside the eyeball will increase

When periorbital cellulite reaches this stage, it will progress very rapidly

 

Stage 4 Periorbital cellulitis:

  • At this stage, the abscess also crosses the septum and an orbital abscess develops.
  • Increased droopy eyelids (eyelid ptosis)
  • Increased symptoms of eye inflammation
  • Ocular muscle paralysis
  • Severe visual impairment
  • Fever and the spread of infection in the blood and as a result the spread of infection to the whole body (sepsis)

 

Stage 5 Periorbital cellulite:

Central nervous system involvement, severe headache, nausea and vomiting, and cerebral vein thrombosis (cavernous sinus thrombosis)

 

What causes periorbital cellulite?

  • Bacteria Staphylococcus, Streptococcus:

These infectious agents may enter through an insect bite site on the eyelid or around the eye, or they may enter and infect through scratches around the eyelid and on the eyelid.

  • Chalazion:

It can cause or exacerbate periorbital cellulite itself

  • Sinusitis
  • Respiratory infections, such as infections of the throat, nose, and sinuses:

Sinus infections, especially in children, are the most common underlying cause of periorbital cellulitis.

Infection is easily transmitted through the very thin wall between the sinuses and the eyeball. In children, the maxillary sinuses and the sinuses around the back of the nose can become infected with the flu virus and transmit the infection to the eyeball.

  • Eye surgery
  • Inflammation of other organs of the head and neck:

If there is an inflammatory and infectious condition in:

  • the face
  • Throat
  • Teeth and gums
  • Inside the skull
  • Foreign body entry and inflammation and underlying infection in the eye
  • Chronic sinusitis or acute sinusitis, allergies, trauma and nasal and sinus polyps

 

Provide the basis for the formation of periorbital cellulite.

In adults, the most common bacterial agent is Staphylococcus and Streptococcus, and in children, the most common bacterial agent is Haemophilus influenzae.

The worldwide spread of infections can also reach the eyes and cause periorbital cellulitis.

 

Symptoms of orbital cellulitis

  • Redness around the eyes
  • Red and white inside the eyes
  • Swelling and eyelid edema
  • The affected eye becomes sensitive to touch
  • Fever may or may not be present

 

The above symptoms occur in the first stage of periorbital cellulite. If you have some of the symptoms above, you must be examined immediately by an ophthalmologist.

 

In advanced stages:

  • Fever
  • Droopy eye or ptosis of the eyelid
  • Eyeball coming forward !!!
  • Eye pain, especially when the eyeball moves
  • Restriction of eyeball movements
  • Visual impairment
  • Clots in the cerebral arteries
  • Increased intraocular pressure
  • Paralysis of eye movements
  • Periorbital cellulitis usually affects one eye.

 

Diagnosis

  1. Blood culture must be performed for infection, on the other hand eye secretions must be cultured.
  2. CBC to study white blood cell count
  3. CT scan to check for sinusitis, abscess and etc.

 

treatment

If a patient has periorbital cellulite, he or she should be hospitalized for antibiotics.

If the patient's vision is less than 20/60, discharge and infection should be surgically removed.

 

Antibiotic treatment:

  • Nafcillin
  • Ceftazidime
  • Ceftriaxone
  • vancomycin
  • clindamycin
  • metronidazole
  • gentamicin

 

When treatment begins, your doctor will use two or three of the above antibiotics to treat you at the same time, such as combination:

Initiates ceftazidime, metronidazole, and vancomycin for hospitalized patients (intravenously)

With the improvement of the patient's condition and the obvious elimination of the inflammatory symptoms, the drugs are converted from the form of intravenous injection to the oral form.

Intravenous and oral medications should be taken for a total of fourteen days.

 

Complications of periorbital cellulite

Periorbital cellulite can lead to cellulite and eyeball infection or orbital cellulite. Untreated orbital cellulite can lead to permanent blindness, neurological problems, meningitis and worldwide infection.

 

How to prevent periorbital cellulite?

Do not ignore sinus infections and infections of the mouth, teeth and throat as these infections can spread to the eyes and cause periorbital cellulitis.

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