Infections

An infection may spread from the sinuses, teeth, or bloodstream to the orbit. Infection of the orbit is called orbital cellulitis. Eye infections may develop after an injury. Symptoms include pain, a bulging eye, reduced eye movement, swollen eyelids, and fever. The eyeball has a swollen, indistinct appearance. Vision may be impaired.

Without adequate treatment, orbital cellulitis can lead to blindness. Infection can spread to the brain and spinal cord, or blood clots can form and spread from the veins around the eye to involve a large vein at the base of the brain (the cavernous sinus) and result in cavernous sinus thrombosis.

See the sidebar Cavernous Sinus Thrombosis.

Diagnosis and Treatment

Doctors can usually recognize orbital cellulitis without using diagnostic tests. However, determining the cause may require further assessment, including examination of the teeth and mouth and x-rays or computed tomography (CT) of the sinuses. Often, doctors obtain samples from the lining of the eye and from the skin, throat, or sinuses as well as blood samples and send them to a laboratory for testing. The samples are cultured (to grow organisms) to determine where the infection that gave rise to the orbital cellulitis is located, which type of organism is causing the infection, and which treatment should be used.

Antibiotics are started before the results of the laboratory testing are known. Oral antibiotics are given for mild cases; intravenous antibiotics are given for severe cases. The antibiotic used at first may be changed if the culture results suggest that another drug would be more effective. Sometimes surgery is needed to drain a collection of pus (abscess) or an infected sinus.