Eyelid cellulitis is an infection of the eyelid. There are two variations of the condition: perseptal cellulitis and orbital cellulitis. A prespetal, or periorbital, infection is an infection of the eyelid itself and the surrounding skin. An orbital infection is an infection that spreads past the eyelid into the tissue of the posterior section of the eye. While both are serious infections that usually require medical treatment, orbital cellulitis is the more serious of the two. It can cause blindness, or even death, if not treated immediately.
Infections of the eye are not usually caused by direct injury. More often, eyelid cellulitis begins as a sinus infection that spreads to the eyes. Strep and staph infections are the most common. Fungi can also cause certain types of eye infections, but this is far less common. Usually an infection of the eye caused by a type of fungus only happens in those with an immune disorder or diabetes.
Symptoms for both types of eyelid cellulitis are similar at first and include swelling, warmth, redness, followed by an inability to open the eye completely. However, orbital infections quickly develop additional symptoms that show how serious the condition is. The swelling and redness will usually spread to the surrounding area, forcing the eye to swell shut. Eye movement will become incredibly painful, and if the person can open their eye they will notice a decrease in vision.
The formation of abscesses, which are puss-filled cavities, surrounding the eye may occur as well. An orbital infection of the eye can spread quickly, leading to meningitis, and the symptoms associated with that condition, such as fever, headaches and disorientation. Meningitis, which is a swelling of the brain and spinal cord, can be fatal. Furthermore, damage cause by an advanced orbital cellulitis can lead to loss of vision in the affected eye.
Diagnosis is done by clinical examination. If the only visible signs of infection are in the eyelid, then a diagnosis of preseptal cellulitis is usually made. If the infection has shown signs of spreading to other parts of the eye, or if the patient is exhibiting more severe symptoms, then a doctor may do a CT or MRI scan to determine the severity of the infection.
If a diagnosis of perseptal eyelid cellulitis is made, a doctor may still have the patient stay overnight in hospital just to make sure the infection does not spread. During this time, and for several days after, the patient will be prescribed antibiotics to help fight off the infection and prevent further damage. After the infection has appeared to vanish, additional check ups are often by made to ensure all traces of cellulitis have been removed and the eye has fully recovered. In most cases there are no long term side effects to perseptal cellulitis.
If a diagnosis of orbital eyelid cellulitis is made, then the patient will most likely be admitted to the hospital for emergency treatment. Strong antibiotics to fight the eye infection are given, as are antibiotics for meningitis as a precautionary measure. In extreme cases of infection, surgery might be performed to remove the infected areas. The sooner an orbital infection is treated, the less likely serious side effects, such as permanent vision loss, will occur. If left untreated, an orbital infection of the eye, and the meningitis that usually follows, will be fatal.
