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.