Specific Management: Preseptal Cellulitis

Most patients with preseptal cellulitis can be managed with oral antibiotics (e.g. co-amoxiclav) on an outpatient basis, with daily review in the ED or ophthalmology review clinic, according to local policy. [8]
Admission and intravenous antibiotic therapy should be considered:

• If there is doubt as to the diagnosis, especially if orbital cellulitis is possible
• Where there is progression or failure of resolution despite oral therapy
• If there are signs of systemic illness

If a patient is going to be discharged, they should be carefully counselled to seek urgent review if their condition deteriorates.

Learning bite

If there is any doubt as to whether a patient has preseptal or orbital cellulitis, a second opinion must be sought from an ophthalmologist or senior ED doctor.