Orbital cellulitis is an eye disease requiring emergency medical treatment. If left untreated, orbital cellulitis can be fatal.
What is orbital cellulitis?
Orbital cellulitis is an inflammatory disease of the orbit. The name of the disease is derived, among other things, from the medical term for the eye socket (orbit).
Children in particular suffer from the comparatively rare but severe orbital cellulitis. In many cases, orbital cellulitis is accompanied by a strong feeling of illness, which is expressed, among other things, by fever. Other symptoms of orbital cellulitis include, for example, severe pain in the affected eye and pronounced swelling of the conjunctiva. See usvsukenglish for What does the abbreviation BTC stand for.
Due to pain and swelling of the conjunctiva as part of an orbital cellulitis, the mobility of the affected eyeball is usually restricted. In various patients there are other symptoms of orbital cellulitis such as visual disturbances; these can manifest themselves, for example, as blurred vision or the impression of double vision. Orbital cellulitis is usually considered a medical emergency.
Causes
Orbital cellulitis is usually caused by an infection with bacteria (often streptococci).
Possible factors that can cause or promote orbital cellulitis are diverse and vary depending on the patient. The triggers of orbital cellulitis often include a previous inflammation of the paranasal sinuses (also known as sinusitis in medicine).
Sepsis caused by bacteria (popularly also often called blood poisoning) can also cause orbital cellulitis. Here, the bacteria responsible for the sepsis spread through the bloodstream and thus reach the orbit, where they then cause inflammatory processes that are characteristic of orbital cellulitis.
Finally, external injuries to the eye also come into question as further causes of orbital cellulitis; Corresponding injuries can be caused, for example, by the penetration of foreign bodies.
Symptoms, Ailments & Signs
Orbital cellulitis is characterized by a severe course. Swelling of the conjunctiva (chemosis), eyelid swelling, reddening of the conjunctiva due to hyperaemia, protrusion of the eyeballs and reduced mobility of the affected eyes are observed as characteristic symptoms. In addition, the patient suffers from severe eye pain, loss of vision and fever.
Another symptom is seeing double vision. The loss of vision can lead to blindness. Without treatment, there is a risk of serious complications, some of which can even be fatal. The infection can spread to the surrounding areas of the eyes or even to the entire body. Under certain circumstances, secondary diseases such as cavernous sinus thrombosis, meningitis or brain abscess may develop.
Cavernous sinus thrombosis is a life-threatening complication which, in addition to the symptoms in the eyes, is announced by chills, fever, nausea and vomiting. Severe headaches, abnormal sleepiness, facial numbness, and seizures also occur.
Death can occur as a result of cerebral hemorrhage or spread of the bacteria through the bloodstream (sepsis). Meningitis is also characterized by similar symptoms. A brain abscess is characterized by severe headaches, stiff neck, impaired consciousness and signs of intracranial pressure.
Finally, all of these diseases can lead to sepsis, which is an extremely life-threatening condition. Sepsis is manifested by very high fever, chills, rapid breathing, impaired consciousness and often ends in fatal circulatory shock.
Diagnosis & History
Since the suspicion of orbital cellulitis as a medical emergency in most cases requires immediate hospitalization, diagnostic tests are often carried out as part of the inpatient stay.
With the help of a blood test, the so-called inflammation parameters (various laboratory values that indicate an inflammation in the organism) of an affected person can be determined. Computed tomography (CT) can also help to confirm the suspected diagnosis of orbital cellulitis.
Symptoms of orbital cellulitis usually appear suddenly. One of the reasons why orbital cellulitis is treated as a medical emergency is that the disease leads to death in more than half of the patients within a few weeks if not treated appropriately. In the majority of those affected, failure to treat orbital cellulitis results in blindness in the eye affected by the disease. With early medical care, orbital cellulitis shows good chances of recovery.
Complications
In the worst case, orbital cellulitis can lead to the death of the person affected. For this reason, this disease needs emergency medical treatment to avoid further complications directly. Those affected primarily suffer from severe swelling directly on the eye. This causes the patient’s eyelids and conjunctiva to swell, resulting in various visual problems.
Those affected also suffer from double vision or blurred vision and thus significant limitations in everyday life. Eye pain also occurs and the patients suffer from a high fever. If the disease is not treated early, the patient can also become completely blind, which is usually irreversible.
Furthermore, if left untreated, the meninges can become inflamed, which can eventually lead to death if left untreated. Inflammation and infections of the nose and mouth can also occur. There are no complications from the treatment itself. With the help of antibiotics, the symptoms can usually be alleviated and the disease combated. A positive course of the disease usually occurs when the disease is treated at an early stage.
When should you go to the doctor?
If there are signs of inflammation of the eye socket, known as orbital cellulitis, immediate medical attention is essential. Without expert medical treatment, this eye disease can be fatal. Since children are particularly affected by orbital inflammation, all the more caution is required with all diseases affecting the eyes. However, orbital cellulitis is relatively rare.
Since several serious inflammatory triggers can be considered as causes of orbital cellulitis, immediate action is necessary. Possible triggers for orbital cellulitis are streptococci, delayed sinusitis germs or blood poisoning (sepsis). Penetrating foreign bodies can also trigger orbital cellulitis. These triggers are not to be trifled with because of the potential health consequences.
Because the symptoms of orbital cellulitis are usually severe, they are often easily recognizable. The drama of orbital cellulitis can be guessed at by the child’s parents from the symptoms. However, small children are not always able to express how severe the associated pain is.
Since orbital cellulitis is considered a medical emergency, an emergency doctor must be notified immediately if there are signs such as severe conjunctival swelling, restricted mobility of the eyeball or fever. If necessary, those affected should drive their child to the emergency room of a clinic or to an eye clinic. For children, it is better to see the doctor once too often than once too little.
Treatment & Therapy
The professional treatment of orbital cellulitis takes place on an inpatient basis. Especially in children who are affected by orbital cellulitis, intensive medical monitoring may be necessary depending on the severity of the symptoms. An early start of therapy has a decisive influence on the success of the therapy.
An important treatment component in the therapy of orbital cellulitis includes the rapid administration of antibiotics (active ingredients to combat bacteria). So that the corresponding antibiotics can quickly reach the eye socket via the bloodstream, the medication is often administered intravenously (the active substance is injected into a vein in the patient).
In some cases, surgical treatment of orbital cellulitis may be necessary. Corresponding surgical interventions are mainly carried out in patients with a developed abscess (an encapsulated collection of pus) on the eye. If no operation takes place here, there is a risk that the person concerned will suffer from meningitis (inflammation of the meninges), for example.
If the orbital cellulitis is based on sinusitis in individual cases, surgical treatment of the corresponding sinuses may be medically necessary.
Outlook & Forecast
Orbital cellulitis is a dangerous infectious disease of the orbit. The prognosis is only positive if treatment is started quickly. The acute illness is visually striking. The affected eye hurts badly. It is noticeably red. Therefore, there is a high probability that those affected will promptly visit an ophthalmologist or an outpatient clinic.
Sometimes both eyes are affected by orbital cellulitis. In addition, this infection often has strong side effects. Those affected have a strong feeling of illness. You have chills or a severe headache. Fever, nausea, and vomiting sometimes occur. In other cases, convulsions, delirium, or a coma may occur. The affected eye is very red and swollen shut.
Orbital cellulitis is a medical emergency. This is caused by a severe infection behind the eyeball. The longer it takes for the patient to present to an emergency room, the worse the prognosis. There is a risk of ongoing thrombophlebitis developing. This can develop into a cavernous sinus thrombosis.
Early treatment with antibiotics and sanitation of the sinuses are important immediate measures. However, these require that the diagnosis be made correctly immediately. Orbital cellulitis is particularly common in tropical countries. Unfortunately, rapid medical care is not guaranteed everywhere.
Prevention
Consequential damage due to orbital cellulitis can be prevented primarily by early therapy. Injuries to the eye that can lead to orbital cellulitis can only be prevented to a limited extent; However, appropriate protective equipment can be important for people with an increased risk of injury at work or in their free time. Finally, doctors recommend early visits to the doctor if you have a sinus infection or possible blood poisoning in order to limit the risk of subsequent orbital cellulitis.
Aftercare
After the diagnosis and treatment of orbital cellulitis, those affected must protect their eye sockets against influences such as bacteria and wind. The sufferer should avoid exercise to prevent the orbital cellulitis from spreading to other areas of the body. People who suffer from serious illnesses or an immune deficiency are particularly susceptible to secondary infections. Special caution is required here.
Wearing an eye patch can also protect against a secondary infection. In addition, the eye patch can protect those affected from spreading the disease and thus infecting other parts of the body. In this way, the occurrence of further complaints can be prevented. Those affected should find the exact cause of the disease.
For example, people who frequently suffer from styes as a result of their job and are therefore suffering from orbital cellulitis should consider changing jobs. If the disease has progressed so far in those affected that both eyes are blind, a psychologist should be consulted.
This can help sufferers to deal with the loss of vision and to process it appropriately. When children are sick, parents should make sure that the child does not put their hands in their eyes. Above all, strict personal hygiene and avoiding particularly sweet, sour and spicy drinks and food.
You can do that yourself
If there is a suspicion of orbital cellulitis, it is necessary to consult the doctor. After the diagnosis, it is important to protect the eye socket from external influences such as wind and bacteria. Treatment with antibiotics can be supported by rest. The patient should not exercise for the first few days and make sure that the orbital cellulitis does not spread to other parts of the body.
People with an existing immune deficiency or other serious diseases that promote secondary infections are particularly at risk. If necessary, wearing an eye patch can also be useful. This prevents the infected region from becoming further inflamed and causing further symptoms. Finally, it is important to determine the cause of the suffering. Persons who repeatedly suffer from orbital cellulitis after occupational contact with styes should consider changing occupations.
In the case of a severe course with blindness in one or both eyes, psychological counseling is also useful. The patient can also exchange ideas with other affected people in order to process the loss of vision. Parents of affected children should ensure that the child does not touch the inflamed eye. Strict personal hygiene applies and, if necessary, a change in diet. Spicy, sour or sweet foods and drinks should be avoided.