Orbital Cellulitis Definition, Reason, Symptoms, Treatment & Prevention
Definition
Orbital cellulitis is the term used to describe an infectious condition of the soft tissues of the orbit, especially the posterior part of the orbital septum. The orbital septum is a structure of the eye that lines the anterior (front) part of the orbit (eyeball), also known as the eyelids. If the infection occurs on the front of the orbital septum, it is called preseptal cellulitis. These two conditions can be found either simultaneously or separately.
In general, orbital cellulitis is more common in children, especially those aged 7–12 years. This condition needs to be recognized early and get appropriate treatment as soon as possible because it can cause various complications. In fact, 11 percent of cases of orbital cellulitis can lead to vision loss (blindness).
Orbital Cellulitis Symptoms
Some of the common signs and symptoms of orbital cellulitis are:
- Reduced eye movement and pain when moving the eye
- Proptosis (abnormal protrusion of the eye)
- Chemosis (swelling of the conjunctiva of the eye)
- Redness of the eyes
- Increased eye pressure
- Fever
- Disturbance or loss of vision
- Feeling weak or tired
- Headache
- Discharge from the nose, can be a purulent discharge (infectious mucus)
Orbital Cellulitis Reason
Some of the causes that can cause orbital cellulitis are:
- Continuing infection in the area of the paranasal sinuses (around the nose) or other structures around the eyes (face, tear glands, etc.)
Various structures around the eye that are infected can cause the spread of infection to develop orbital cellulitis. In 90 percent of cases, this spread originates from the ethmoidal sinusitis. Infection can also come from the teeth and mouth area.
- Direct infection of the eye, for example due to trauma or surgery. Trauma to the eye, whether intentional or not, can cause material to enter the eyeball that can infect it.
- Spread of bacterial infection through the blood. The most common causes are Streptococcus, Staphylococcus aureus, and Haemophilus influenzae type B.
- Most often caused by the type of fungus Mucor and Aspergillus.
Diagnosis
To determine the diagnosis of orbital cellulitis requires a thorough evaluation consisting of:
- Detailed anamnesis or medical interview that aims to dig up information about the signs and symptoms you are feeling, and possible causes (the presence of sinusitis, tissue infections around the eyes, trauma, tooth infections, and so on).
- Physical examination. A thorough eye examination and temperature measurement are required.
- Investigations, usually in the form of laboratory tests and imaging tests. Laboratory tests such as leukocytosis on a complete blood count, blood culture to determine the germs that cause infection and swab examination of the discharge from the nose. While imaging examinations are usually carried out such as a CT- scan or MRI of the eye.
Orbital Cellulitis Treatment
Treatment of orbital cellulitis often requires hospitalization. In cases caused by bacteria, it is usually necessary to administer antibiotics through a vein. Sufferers can also be given decongestant drugs for the nose. After completion of hospitalization, generally antibiotic treatment needs to be continued for 1-3 weeks at home.
The doctor will consider surgery for sinus drainage, especially if things like:
- The response to antibiotic therapy for 24–48 hours is poor
- Presence of a large intraorbital abscess or subperiosteal abscess (abscess from the jaw area that spreads to the eye bag area)
- CT- scan shows sinus conditions that appear completely opaque
In this procedure, the doctor will install a drainage device that can be left in place for several days before being removed again.
If it is caused by a fungal infection, it is generally recommended to undergo surgery for debridement or removal of damaged tissue. In addition, therapy using corticosteroid-type drugs, both topically / used locally and systemically, can also be recommended.
Without proper treatment, various complications can arise. These include orbital apex syndrome and eye blindness. In addition to the effects on the eyes, cavernous sinus thrombosis (blockage of blood vessels, which is quite rare), intracranial abscess (abscess in the brain), meningitis, and even death can occur.
Prevention
Orbital cellulitis disorders cannot be simply prevented because they are related to infections that can strike at any time. Recognize and immediately seek medical help if there are signs of infection around the nose, ears, throat and eyes that look quite severe.
Maintaining the immune system is certainly highly recommended to banish disease germs. Also keep your eyes clean and healthy by not rubbing your eyes carelessly with dirty hands, cleaning and changing contact lenses according to the rules, and making sure your eyes get enough rest.