Periorbital cellulitis is a skin infection that affects your eyelid or the area around your eye. It’s most common in children, but adults can get it, too. Antibiotics can usually treat it effectively.

Periorbital cellulitis is a type of eyelid infection. Also called preseptal cellulitis, the infection develops within tissues only, sparing the rest of the eye structure. While anyone can develop periorbital cellulitis, it’s most common in young children.

If you or your child is exhibiting signs of inflammation or infection around the eye area, consider talking with a doctor to rule out a potentially serious condition. While periorbital cellulitis isn’t usually life threatening, treatment is needed to prevent complications.

Here’s what you need to know about the symptoms and risk factors for periorbital cellulitis and the treatment options a doctor may consider.

Periorbital cellulitis vs. orbital cellulitis

Both periorbital cellulitis and orbital cellulitis involve inflammation and an infection around your eye.

The key difference is that periorbital cellulitis affects tissues in front of the septum of your eye (“preseptal”), while orbital cellulitis affects tissues behind it. The septum is the thin membrane that protects the orbit of your eye.

Orbital cellulitis is also more likely to cause eye pain and vision problems. It’s a much more serious condition that can also sometimes become life threatening.

The only way to definitively distinguish between these two conditions is through imaging tests, primarily CT scans.

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Symptoms of periorbital cellulitis affect only one eye and may include:

  • eyelid swelling
  • eye discomfort (but not pain)
  • difficulty opening the affected eye
  • red eyes
  • fever
  • fatigue

Contact a doctor right away if you or your child are experiencing a bulging eye, double vision, or problems moving your eye. These may be signs of orbital cellulitis, a more serious condition.

Bacterial infections typically cause periorbital cellulitis. The most common bacterial causes are:

Some cases may also be related to fungal infections.

The most common events that cause this infection are accidental scratches or insect bites near your eye. When the skin is opened up or irritated in this way, bacteria may enter the tissues, leading to an infection.

Periorbital cellulitis may also develop from other infections that spread to the orbital septum. These can include sinus infections. Due to the proximity of the sinuses to the eye area, an infection may develop and spread.

Young children may be at a higher risk of periorbital cellulitis due to exposure to other children in day care facilities and schools. Constantly rubbing or scratching around your eyes can also increase your risk.

Having a history of asthma or sinusitis may also increase your risk of these types of infections.

People who have mouth, head, or neck surgeries may also be at an increased risk of cellulitis.

A primary care physician or emergency doctor will likely refer you to an ophthalmologist for further evaluation and treatment.

To diagnose periorbital cellulitis, an opthalmologist may conduct or order the following tests:

  • An eye exam: They’ll look for possible signs of cellulitis around your eye, such as inflammation and eyeball movements.
  • Health evaluation: A doctor will ask if you’ve had any recent infections or injuries, particularly around the eye area. They may also consider any recent surgeries.
  • Tissue tests: If a doctor suspects periorbital cellulitis, they may take a small tissue sample from your nose or eye and send it to a lab for further evaluation.
  • Blood tests: Blood tests are typically negative in people with periorbital cellulitis, but a doctor may order one if they suspect orbital cellulitis.
  • Imaging tests: This usually involves a computed tomography (CT) scan and can help a doctor rule out orbital cellulitis.

Young children may require a sedative or anesthetic to undergo a CT scan.

Treatment for periorbital cellulitis consists of oral antibiotics to help get rid of the underlying infection. While you may notice that your symptoms improve within 1–2 days, it’s important to finish your medications as prescribed so the infection doesn’t return.

Potential antibiotic options include:

Doctors usually prescribe oral antibiotics, meaning you take them by mouth. Children with periorbital cellulitis may need to receive intravenous (IV) antibiotics in a hospital for a few days.

To help ease eyelid swelling and discomfort, you may also apply cool compresses to the area.

Periorbital cellulitis is treatable with antibiotics and rarely leads to serious complications. Most people see an improvement in their symptoms within 48 hours.

However, complications can occur if the condition goes untreated. The infection may spread to your eye or other parts of the body. This could lead to:

See a doctor if your symptoms don’t improve within 48 hours to avoid potential complications.

Since periorbital cellulitis is often due to a sinus infection, you might be able to prevent this condition by practicing good hand hygiene and staying away from others who might be sick. An annual flu shot can also help you stay well and prevent complications like cellulitis.

Also, be sure to clean any insect bites or wounds and to watch for signs of infection.

Before talking with a doctor about periorbital cellulitis, consider the following frequently asked questions about this eyelid infection.

How serious is periorbital cellulitis?

Periorbital cellulitis doesn’t usually lead to serious complications. However, untreated periorbital cellulitis can spread to other parts of the body.

Should I go to the ER for periorbital cellulitis?

Periorbital cellulitis doesn’t usually require emergency medical attention. It’s treatable with prescription oral antibiotics from a regular visit to your doctor or urgent care professional.

Orbital cellulitis, on the other hand, requires hospitalization. A pediatrician may advise that you take your child to the hospital for periorbital cellulitis if they’re younger than 12 months old.

Does periorbital cellulitis progress to orbital cellulitis?

Without treatment, periorbital cellulitis can progress to orbital cellulitis. The latter is a serious condition that can cause permanent eye damage. It may also be fatal in some cases.

Preorbital cellulitis is more likely to progress to orbital cellulitis in children.

Periorbital cellulitis is an infection that develops within eyelid tissues or other nearby tissue, leading to telltale signs, such as extreme swelling. This infection is more common in children, but anyone can develop it. Sinus infections, surgeries, and wounds can all increase your risk.

Periorbital cellulitis is treatable, with a prompt diagnosis likely to decrease your risk of further complications. However, since this condition can progress into more serious eye problems, it’s important to see a doctor for an accurate diagnosis and treatment.