Periorbital and orbital cellulitis

Overview 
Theory 
Diagnosis 
Management 
Follow up 
Resources 

Periorbital cellulitis

Clinical improvement is usually seen within 24-48 hours. The prognosis is excellent, with full resolution in almost all cases.[1][9] Progression to orbital cellulitis in immunocompetent adults with no underlying risk factors is rare.

Orbital cellulitis

A lag time of 24-48 hours commonly occurs between initiation of antibiotics and clinical response. If there is no improvement or if new signs develop, such as decreased vision or a relative afferent pupillary defect, repeat the CT scan and suspect abscess formation or resistant organisms. Prognosis depends on any underlying risk factors (e.g., immunocompromise) or additional findings (e.g., an abscess). Prompt and proper antibiotic treatment and drainage of sinusitis is critical to avoid progression to subperiosteal orbital abscess, epidural abscess, and meningitis. Frontal sinus infection carries a worse prognosis due to the risk of intracranial spread from a corresponding subperiosteal orbital abscess.[19]

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