Context

Most external eye infections pose little risk to life or vision.
Orbital cellulitis is the exception. While antibiotics have reduced the historical mortality rate from 17% to less than 1%, blindness of the affected eye still occurs in 11% of patients [1,2]. The emergence of antibiotic resistant strains of bacteria has led to a recent increase in this rate, even amongst those receiving prompt treatment [3,4].

The challenge

The vast majority of external eye infections are benign, self-limiting conditions.
The challenge for the emergency physician (EP) is to provide appropriate advice and reassurance for these patients, while correctly identifying those with life- or sight-threatening problems.

Learning Bite

Although most external eye infections are relatively benign, orbital cellulitis still carries a significant risk of blindness in the affected eye.