Periorbital and Orbital Cellulitis

• Eyelid swelling is a common pediatric complaint and must be evaluated expeditiously by a pediatrician. • Based primarily on consensus and observational studies, differentiation of periorbital and orbital cellulitis must be attempted through thorough history taking, including predisposing factors, and physical examination focused on the eye. (5) • CT scan scanning may aid in the diagnosis, according to primarily consensus and observational studies. (3) • Based primarily on consensus and observational studies, simple periorbital cellulitis may be treated empirically with oral antibiotic therapy and close follow-up. (10) • Consensus and observational studies suggest that early recognition and treatment of orbital cellulitis is essential. (2) • When a patient presents with ophthalmoplegia and proptosis, consensus and observational studies recommend initiation of appropriate empiric antibiotic therapy targeted at MRSA and Streptococcus. (6) • Based primarily on consensus and observational studies, the patient's clinical course must be monitored closely, with clinical deterioration or lack of improvement possibly requiring imaging to look for underlying complications and determine the need for surgical intervention.