Orbital cellulitis (Pediatrics - PEDS)

Medium urgency
-Moderately severe
This is a rare but dangerous infection of the tissue surrounding the eye (eyelids, cheeks and inside the eye). It occurs more in childhood as a complication of sinusitis (or another infection) that progresses to the eye. It causes fever, red eyes and swelling of the eyelid, as well as bulging eyes, double vision or loss of vision. Diagnosis is clinical. If possible, the pus that is excreted is cultured to identify the bacteria responsible. It is treated with intravenous antibiotics. It is a medical emergency if the eye pops out of its socket or if you cannot move it, or if you experience loss of vision; go to a hospital with an ophthalmology department to assess your case. Surgery is sometimes necessary.
Bibliographic references
  1. Christopher Gappy, MD. Steven M Archer, MD. Michael Barza, MD. Orbital cellulitis. UpToDate. Jan 04, 2016.
  2. Botting AM, McIntosh D, Mahadevan M. Paediatric pre- and post-septal peri-orbital infections are different diseases. A retrospective review of 262 cases. Int J Pediatr Otorhinolaryngol 2008; 72:377.
  3. Seltz LB, Smith J, Durairaj VD, et al. Microbiology and antibiotic management of orbital cellulitis. Pediatrics 2011; 127:e566.
  4. Nageswaran S, Woods CR, Benjamin DK Jr, et al. Orbital cellulitis in children. Pediatr Infect Dis J 2006; 25:695.
Author
Dr. Sara Vitoria
Copyright
© TeckelMedical 2026

Symptoms

    Fever / Feel very hot


    High fever of 40ºC/104ºF or above


    Swollen eyelid


    Pain with eye movement


    Reddened eyelid

Pre-hospital care recommendations

Take over-the-counter pain relievers or anti-inflammatories.
Apply cold compresses 3 times a day for 20 minutes to reduce the symptoms.