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Periorbital cellulitis

Preseptal cellulitis

Periorbital cellulitis is an infection of the eyelid or skin around the eye.

Causes

Periorbital cellulitis can occur at any age, but more commonly affects children younger than 5 years old.

This infection can occur after a scratch, injury, or bug bite around the eye, which allows germs to enter the wound. It can also extend from a nearby site that is infected, such as the sinuses.

Periorbital cellulitis is different than orbital cellulitis, which is an infection of the fat and muscles around the eye. In contrast to periorbital cellulitis, orbital cellulitis is a dangerous infection, which can cause lasting problems and deeper infections.

Symptoms

Symptoms include:

  • Redness around the eye or in the white part of the eye
  • Swelling of the eyelid, whites of eyes, and surrounding area

This condition usually does not affect vision or cause eye pain.

Exams and Tests

Your health care provider will examine the eye, especially, eye movements and test for vision, and ask about the symptoms.

Tests that may be ordered include:

Treatment

Antibiotics are given by mouth, by shots, or through a vein (intravenously; IV) to help fight the infection.

Outlook (Prognosis)

Periorbital cellulitis almost always improves with treatment. In rare cases, the infection spreads into the eye socket, resulting in orbital cellulitis.

When to Contact a Medical Professional

Contact your provider right away if:

  • The eye becomes red or swollen
  • Symptoms get worse after treatment
  • Fever develops along with eye symptoms
  • It is difficult or painful to move the eye
  • The eye looks like it is sticking (bulging) out
  • There are vision changes
Open References

References

Durand ML. Periocular infections. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 116.

Olitsky SE, Marsh JD, Jackson MA. Orbital infections. In: Kliegman RM, St. Geme JW, Blum NJ, ed. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 674.

  • Periorbital cellulitis

    Periorbital cellulitis - illustration

    Periorbital cellulitis is an acute infection of the tissues surrounding the eye, which may progress to orbital cellulitis with protrusion of the eyeball. Complications include meningitis.

    Periorbital cellulitis

    illustration

  • Haemophilus influenzae organism

    Haemophilus influenzae organism - illustration

    This is a Gram stain of spinal fluid from a person with meningitis. The rod-like organisms seen in the fluid are Haemophilus influenzae, one of the most common causes of childhood meningitis (prior to the widespread use of the H influenzae vaccine). The large red-colored objects are cells in the spinal fluid. A vaccine to prevent infection by Haemophilus influenzae (type B) is available as one of the routine childhood immunizations (Hib), typically given at 2, 4, and 12 months.

    Haemophilus influenzae organism

    illustration

  • Periorbital cellulitis

    Periorbital cellulitis - illustration

    Periorbital cellulitis is an acute infection of the tissues surrounding the eye, which may progress to orbital cellulitis with protrusion of the eyeball. Complications include meningitis.

    Periorbital cellulitis

    illustration

  • Haemophilus influenzae organism

    Haemophilus influenzae organism - illustration

    This is a Gram stain of spinal fluid from a person with meningitis. The rod-like organisms seen in the fluid are Haemophilus influenzae, one of the most common causes of childhood meningitis (prior to the widespread use of the H influenzae vaccine). The large red-colored objects are cells in the spinal fluid. A vaccine to prevent infection by Haemophilus influenzae (type B) is available as one of the routine childhood immunizations (Hib), typically given at 2, 4, and 12 months.

    Haemophilus influenzae organism

    illustration

 

Review Date: 12/31/2023

Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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