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Preseptal or Orbital Cellulitis

The eyelid skin is naturally separated from the eye and the surrounding “orbital” structures by a thin (“nylon-like”) sheet that is called the orbital “septum.”Preseptal cellulitis is a superficial (bacterial) infection of the eyelid that has not penetrated the orbital septum, and has not spread to the actual orbit. It may be caused by breaks in the skin around the eye (scratches, cuts, and insect bites). Periorbital cellulitis must be differentiated from orbital cellulitis, which is infection of the eyelid skin that has penetrated the orbital septum and involves the orbital structures. This is a true emergency and requires immediate intravenous (IV) antibiotics. With both of these conditions, affected individuals may experience the following; swelling, redness, discharge, pain, shut eye, conjunctival injection and fever. Treatment with antibiotics is aimed at gram positive bacteria. Warm to hot compresses help with pain and inflammation. Antibiotic eye drops keep eye moist and prevent infection to eye or other areas. A lubricant, such as petroleum jelly applied with clean cotton swab, provides relief to dry skin on eyelid due to wiping and fevered skin, as well as making it easier to wipe off drainage and/or prevent crusting. Definitely, seek medical attention if you have these symptoms, but it is generally safe to start applying eye-presses 3-4 times daily until you are properly evaluated by your eye-care professional.

The following reputable links all present detailed information and literature about preseptal and orbital cellulitis and guidance regarding how to best treat it with warm compresses: