Orbital Cellulitis

Key history
Key examination
Initial management
Referral

Key history

• Usually underlying lid lesion, trauma or lacrimal system blockage
• Progressive swelling and erythema of lids with systemic symptoms (fever, malaise)

Key examination

Distinguish from peri orbital cellulitis by reduced VA and colour vision, relevant afferent pupil defect (RAPD), proptosis and limitations of eye movements.

Initial management

• Intravenous antibiotics
• Augmentin 1.2g 8 hourly OR
• Ceftriaxone 2g daily and metronidazole 500mg 8 hourly (if penicillin allergic and tolerates Cephalosporins) OR
• Ciprofloxacin 750mg twice daily and metronidazole (If Cephalosporin allergic)
• CT scan of orbits and sinuses
• Full blood count, blood culture

Referral = Urgent