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Orbital cellulitis and preseptal cellulitis are the major infections of the ocular adnexal and orbital tissues. Orbital cellulitis has various causes and may be associated with serious complications. Prompt diagnosis and proper management are essential for curing the patient with orbital cellulites. Orbital cellulitis occurs in the following 3 situations: (1) extension of infection from the periorbital structures, most commonly from the paranasal sinuses, but also from the face, globe, and lacrimal sac; (2) direct inoculation of the orbit from trauma or surgery; and (3) hematogenous spread from bacteremia. Orbital cellulitis is more common in children than in adults. High-resolution CT scan is essential; however, MRI may be helpful in defining orbital abscesses and in evaluating the possibility of cavernous sinus disease.
Prompt administration of appropriate antibiotics is key to successful treatment of orbital cellulitis. Surgical drainage would be necessary if the response to appropriate antibiotic therapy is poor within 48-72 hours or if the CT scan shows the sinuses to be completely opacified.