The patients with periorbital edema and/or redness, and normal eye movements were diagnosed with preseptal cellulitis, whereas at least one of following findings of limited eye movement, inflammation signs in the conjunctiva, orbital pain, decreased VA (for at least 2 lines on the Snellen chart), afferent pupillary defect signs or radiological imaging detecting inflammation in the orbital region, were accepted for a diagnosis of orbital cellulitis (1-3).
The serum CRP levels were 3.91[+ or -]6.18 mg/dL (minimum: 0.12-maximum: 31) in preseptal cellulitis patients and 9.64[+ or -]0.31 mg/dL (minimum: 9.4-maximum: 10) in orbital cellulitis patients.
Through magnetic resonance imaging (MRI) and/or computed tomography in the orbital region, 13 patients (34.2% of all patients) were diagnosed as follows: sinusitis in 6 patients (46.1%), subperiosteal abscess in 3 patients (23%), preseptal cellulitis in 8 patients (61.5%), and orbital cellulitis in 3 patients (23%).
One patient developed subdural empyema following preseptal cellulitis that developed after sinusitis.
Among the orbital tissue infections, preseptal cellulitis occurs more frequently compared with orbital cellulitis (9, 10).
In preseptal cellulitis, patients generally present with sudden-onset redness, swelling, eye pain, and fever.
In contrast, the more common preseptal cellulitis is usually a milder infection and can often be managed on an outpatient basis.
Preseptal cellulitis is also known as "periorbital cellulitis," but "I don't like that term because it doesn't really tell you what you're dealing with," said Dr.
Orbital cellulitis can arise from paranasal sinusitis; trauma to the eye; a retained foreign body in the orbit; ocular surgery; or contagious spread of infection from adjacent structures, such as dacryocystitis, dental abscesses, or preseptal cellulitis. Ethmoid sinusitis is the most common etiology, she noted.
Though common, preseptal cellulitis or abscess rarely occurs as a complication of sinusitis.
Preseptal cellulitis is infection of the eyelid and surrounding skin anterior to the orbital septum.
In preseptal cellulitis
, the globe is white, vision is good and the extraocular movements are full.