Specific Management: Orbital Cellulitis

When assessing and managing orbital cellulitis, systemic sepsis must be considered, and resuscitation in accordance with standard sepsis guidelines should be initiated [10].
Uncomplicated cases of bacterial orbital cellulitis can be managed with IV antibiotics and observation [8,11].

Surgical intervention is generally indicated if there is:

  • Relative afferent pupillary defect in the affected eye
  • Visual loss
  • Proptosis
  • Lack of progress despite appropriate antibiotic treatment
  • Fluid collection seen on the CT scan

Learning bite

Orbital cellulitis is a medical emergency, requiring prompt initiation of IV antibiotics and referral to an ophthalmologist.