Periorbital cellulitis
Preseptal cellulitis
Periorbital cellulitis is an infection of the eyelid or skin around the eye.
Periorbital cellulitis is an acute infection of the tissues surrounding the eye, which may progress to orbital cellulitis with protrusion of the eyeball. Complications include meningitis.
This is a Gram stain of spinal fluid from a person with meningitis. The rod-like organisms seen in the fluid are Haemophilus influenzae, one of the most common causes of childhood meningitis (prior to the widespread use of the H influenzae vaccine). The large red-colored objects are cells in the spinal fluid. A vaccine to prevent infection by Haemophilus influenzae (type B) is available as one of the routine childhood immunizations (Hib), typically given at 2, 4, and 12 months.
Causes
Periorbital cellulitis can occur at any age, but more commonly affects children younger than 5 years old.
This infection can occur after a scratch, injury, or bug bite around the eye, which allows germs to enter the wound. It can also extend from a nearby site that is infected, such as the sinuses.
Periorbital cellulitis is different than orbital cellulitis, which is an infection of the fat and muscles around the eye. In contrast to periorbital cellulitis, orbital cellulitis is a dangerous infection, which can cause lasting problems and deeper infections.
Symptoms
Symptoms include:
- Redness around the eye or in the white part of the eye
- Swelling of the eyelid, whites of eyes, and surrounding area
This condition usually does not affect vision or cause eye pain.
Exams and Tests
Your health care provider will examine the eye, especially, eye movements and test for vision, and ask about the symptoms.
Tests that may be ordered include:
Treatment
Antibiotics are given by mouth, by shots, or through a vein (intravenously; IV) to help fight the infection.
Outlook (Prognosis)
Periorbital cellulitis almost always improves with treatment. In rare cases, the infection spreads into the eye socket, resulting in orbital cellulitis.
When to Contact a Medical Professional
Contact your provider right away if:
- The eye becomes red or swollen
- Symptoms get worse after treatment
- Fever develops along with eye symptoms
- It is difficult or painful to move the eye
- The eye looks like it is sticking (bulging) out
- There are vision changes
References
Durand ML. Periocular infections. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 116.
Olitsky SE, Marsh JD, Jackson MA. Orbital infections. In: Kliegman RM, St. Geme JW, Blum NJ, ed. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 674.
Version Info
Last reviewed on: 12/31/2023
Reviewed by: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
