No racial or gender predilection exists for adults. However, children are twice as likely as adults to develop peri-orbital and orbital cellulitis. In children, males are twice as likely to develop the condition as females.[1]Robinson A, Beech T, McDermott AL, et al. Investigation and management of adult periorbital or orbital cellulitis. J Laryngol Otol. 2007;121:545-7.
http://www.ncbi.nlm.nih.gov/pubmed/17164026?tool=bestpractice.com
[2]Hamed-Azzam S, AlHashash I, Briscoe D, et al. Common orbital infections ~ state of the art ~ part I. J Ophthalmic Vis Res. 2018 Apr-Jun;13(2):175-82.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5905312
http://www.ncbi.nlm.nih.gov/pubmed/29719647?tool=bestpractice.com
Peri-orbital cellulitis is more common than orbital cellulitis.[3]Georgakopoulos CD, Eliopoulou MI, Stasinos S, et al. Periorbital and orbital cellulitis: a 10-year review of hospitalized children. Eur J Ophthalmol. 2010 Nov-Dec;20(6):1066-72.
http://www.ncbi.nlm.nih.gov/pubmed/20544674?tool=bestpractice.com
Before the routine use of Haemophilus influenzae type b (Hib) vaccination, the incidence of peri-orbital cellulitis associated with Hib bacteraemia was reported to be as high as 80%.[4]Ambati B, Ambati J, Azar N, et al. Periorbital and orbital cellulitis before and after the advent of Haemophilus influenzae type b vaccination. Ophthalmology. 2000;107:1450-3.
http://www.ncbi.nlm.nih.gov/pubmed/10919886?tool=bestpractice.com
Since the introduction of the Hib vaccination, this is extremely rare.[4]Ambati B, Ambati J, Azar N, et al. Periorbital and orbital cellulitis before and after the advent of Haemophilus influenzae type b vaccination. Ophthalmology. 2000;107:1450-3.
http://www.ncbi.nlm.nih.gov/pubmed/10919886?tool=bestpractice.com
Orbital cellulitis is more common in winter months worldwide because of the increased risk of sinusitis.[5]Shih EJ, Chen JK, Tsai PJ, et al. Differences in characteristics, aetiologies, isolated pathogens, and the efficacy of antibiotics in adult patients with preseptal cellulitis and orbital cellulitis between 2000-2009 and 2010-2019. Br J Ophthalmol. 2023 Mar;107(3):331-6.
http://www.ncbi.nlm.nih.gov/pubmed/34607790?tool=bestpractice.com
Estimates of incidence of orbital cellulitis in children range from 1.6 to 9.29 per 100,000 population depending on setting.[6]Murphy C, Livingstone I, Foot B, et al. Orbital cellulitis in Scotland: current incidence, aetiology, management and outcomes. Br J Ophthalmol. 2014 Nov;98(11):1575-8.
http://www.ncbi.nlm.nih.gov/pubmed/24939424?tool=bestpractice.com
[7]A. Soroudi, R. Casey, D. Pan, et al. An epidemiologic survey of orbital cellulitis. Invest Ophthalmol Vis Sci. 2003 May; 44(13):786.
https://iovs.arvojournals.org/article.aspx?articleid=2412865
[8]Bal M, Sanjay C, Vivek B, et al. Orbital cellulitis - incidence, management and outcome from coastal hospitals. J. Pediatr. Crit. CARE. 2019 May-Jun; 6(3): 25-30.
https://journals.lww.com/JPCR/fulltext/2019/06030/Orbital_Cellulitis___Incidence,_Management_and.3.aspx