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Periorbital and Orbital Cellulitis, Emergency Medicine

Reviewed 06/2017



Periorbital Cellulitis

  • An inflammatory, typically infectious condition affecting the eyelid(s)

  • It is anatomically distinguished by its location, isolated to the tissues anterior to the...


Signs and Symptoms

Periorbital Cellulitis/Orbital Cellulitis

  • Both present with a unilateral, red, swollen eye:

    • Lid swelling may be profound in both

  • Differences include:

    • Source of inciting infecti...


Initial Stabilization/Therapy

IV fluids for vomiting, dehydration, toxic appearance, clinical need for parenteral antibiotics 

Ed Treatment/Procedures

  • Antipyretics

  • Pain medication as needed

  • Antib...



Periorbital Cellulitis

Discharge with oral antibiotics and prompt follow-up unless: 
  • Evidence of systemic toxicity, neurologic, visual or orbital findings

  • Unable to tolerate PO antib...

Pearls and Pitfalls

  • Anytime a patient presents with a red swollen eye, consider the possibility of orbital cellulitis

  • Take a careful history for:

    • Recent sinusitis

    • Recent puncture, history of trauma or su...

Additional Reading

  • Hauser  A, Fogarasi  S. Periorbital and orbital cellulitis. Pediatr Rev.  2010;31:242–249.

  • Potter  NJ, Brown  CL, McNab  AA, Orbital cellulitis: Medical and surgical management....



  • 373.13 Abscess of eyelid

  • 682.0 Cellulitis and abscess of face


  • H05.012 Cellulitis of left orbit

  • H05.019 Cellulitis of unspecified orbit

  • H00.039 Abscess of eyelid unspecified eye, unspecified...

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