Cellulitis of Eyelid (Orbital Cellulitis)

Written by Jacquelyn Cafasso | Published on July 18, 2012
Medically Reviewed by George Krucik, MD

What is Cellulitis of the Eyelid?

Cellulitis of the eyelid is an infection caused by bacteria that occur around the eyelid. The disease may also be called preseptal cellulitis or periorbital cellulitis. The infection causes fever, redness, and swelling of the eyelid and the skin near the eyes. It occurs more often in children than in adults.

Cellulitis of the eyelid is not serious if treated early. The infection can usually be effectively treated with antibiotics. However, in some cases it can be more problematic. For example, cellulitis of the eyelid can lead to a serious condition if the infection spreads to the eye socket. An infection of the eye socket, called orbital cellulitis, can cause permanent vision problems or total blindness. It is important to treat cellulitis of the eyelid right away to prevent complications.

What Causes Cellulitis of the Eyelid?

Cellulitis of the eyelid is caused by a bacterial infection. It is more common in children than in adults. The infection might follow a skin injury, like a scratch, or an insect bite around the eye. These conditions allow bacteria to enter the wound and cause infection. The bacteria might also spread from a sinus infection or another upper respiratory infection to the eye. They can also be spread by impetigo, a contagious skin infection.

Common bacteria that are responsible for most cases of periorbital cellulitis include:

  • Haemophilus influenzae
  • Staphylococcus
  • Streptococcus

Haemophilus influenzae is a common cause of sinus infections. It used to be the most common source of periorbital cellulitis. The incidence of preseptal cellulitis caused by Haemophilus influenzae type B (HIB) has declined greatly after the introduction of the HIB vaccine in 1990 (Rimon, et.al., 2008).

What Are The Symptoms of Cellulitis of the Eyelid?

Symptoms of cellulitis of the eyelid may include:

  • redness around the eyelid
  • swelling of the eyelid
  • swelling of the skin around the eyelid

Cellulitis of the eyelid usually does not cause any vision problems or any pain in the eye.

How Is Cellulitis of the Eyelid Diagnosed?

Your doctor will examine the eye. He or she will look at the location of the inflammation. He or she will also ask you about your symptoms. Your doctor will make a diagnosis mainly based on symptoms and the physical exam.

If you or your child is experiencing any pain or vision problems, a doctor may take a blood test or a culture from the drainage to make sure the infection has not spread into the eye itself. This can cause serious complications. Your doctor may use a computed tomography (CT) scan to create images of the structure of the eye. It can help a doctor see the source of the inflammation and how far it has spread.

What Are the Complications of Cellulitis of the Eyelid?

In rare cases, the infection can spread to the eye socket or the eye itself. This can lead to a serious condition called orbital cellulitis.

Orbital cellulitis results in pain, visual problems, and sometimes even blindness. All cases of orbital cellulitis are treated during a hospital stay.

How Is Cellulitis of the Eyelid Treated?

Mild cases of cellulitis of the eyelid in older children and adults can be treated with oral antibiotics, including amoxicillin and dicloxacillin. Be sure to finish all medication prescribed by a doctor. Children younger than four years of age may need antibiotics given intravenously in a hospital setting. A warm compress can be used for inflammation.

In severe cases, or if orbital cellulitis occurs, a patient may need to see a doctor who specializes in diseases of the eye. This type of doctor is called an ophthalmologist. These patients may need constant hospital supervision. They will receive intravenous antibiotics. Surgery may be needed to relieve any pressure that builds up in or around the eye.

What Can Be Expected Long-Term With Cellulitis of the Eyelid?

The prognosis is typically very good with treatment. The condition almost always improves quickly with antibiotics.

You should throw away any makeup products or contact lenses used prior to becoming infected. These products may be contaminated with bacteria.

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Article Sources:

  • Orbital Cellulitis. (2010, July 28). National Library of Medicine - National Institutes of Health. Retrieved July 15, 2012 from http://www.nlm.nih.gov/medlineplus/ency/article/001012.htm
  • Periorbital Cellulitis. (2011, December 6). National Library of Medicine - National Institutes of Health. Retrieved July 15, 2012 from http://www.nlm.nih.gov/medlineplus/ency/article/000976.htm
  • Papier, A., Tuttle, D.J., & Mahar, T.J. (2007). Differential Diagnosis of the Swollen Red Eyelid. American Family Physician, 76(12), 1815-1824.
  • Rimon, A., Hoffer, V., Prais, D., Harel, L., & Amir, J. (2008). Periorbital cellulitis in the era of Haemophilus influenza type B vaccine: predisposing factors and etiologic agents in hospitalized children. Journal of Pediatric Ophthalmology and Strabismus, 45(5), 300-304.

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