- Differential diagnoses include
- Preseptal cellulitis
- Soft tissue infection of eyelids, anterior to orbital septum
- Spread of organisms from contiguous structures – sinusitis, hordeolum, dacrocystitis, eyelid trauma
- Children < 4 incomplete orbital septum – increased risk of orbital cellulitis
- Vision and eye movements normal
- patient systemically well
- aeitology: Staph, strep, HiB, HSV, HZV
- Mx
- Consdier oral vs IV
- flucloxa or diclox
- If concurrent sinusitis or risk factors HiB – Augmentin
- Review within 48 hours to check improving – if not consider treating as orbital cellulitis
- Orbital cellulitis
- Can progress to loss of vision, brain abscess
- Usually from paranasal sinuses
- May be – reduced vision, painful eye mvoemnts, diplopia, proptosis, chemosis, systemically unwell
- Mx – blood cultues, CT san, IV Abx, may need surfical drainage, 4 hrly eye obs
- Viral conjunctivitis (the other eye will be swollen soon plus red and teary)
- Allergic reaction / angiooedema
- Insect bite
- Sinusitis
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