Orbital Cellulitis

Infection in the soft tissues of the orbit, posterior to the orbital septum results in orbital cellulitis. This is a very serious condition, which may occur as a complication of sinusitis by contiguous spread or may result from haematogenous spread or from trauma. Orbital cellulitis presents with periorbital swelling, proptosis, conjunctival chemosis and injection, extraocular motility deficits and visual loss. It requires comanagement by the ophthalmol- ogist and otorhinolaryngologist when secondary to sinusitis. It is important that this condition is recognized early, and immediate management is done to prevent impending visual loss and further complications of periosteal abscesses, meningitis, cavernous sinus thrombosis and death. This chapter reviews the epidemiology of orbital cellulitis, patho- genesis, causative organisms, investigations (including imaging of the sinuses) and treatment. Prognostic factors and conditions that complicate this such as diabetes will also be discussed.