Journal of Clinical and Experimental Ophthalmology
Open Access

Abstract

Orbital Cellulitis: Medical and Surgical Management

Nicholas J. Potter, Christopher L. Brown, Alan A. McNab and Simon Y. Ting

Introduction: Orbital cellulitis is a potential sight-threatening infection of the ocular adnexal structures posterior to the orbital septum. Acute bacterial sinusitis remains the most common cause of orbital cellulitis.
Methods: A retrospective chart review was performed for patients admitted to The Royal Victorian Eye and Ear Hospital with a diagnosis of orbital cellulitis over a five-year period to July 2009.
Results: 78 patients were identified for inclusion in the study, median age 42 years. Sinusitis was the most common predisposing factor, and was present in 52 patients (67%). All patients were treated with intravenous antibiotics. Surgical drainage was required for 28 patients (36%). Of these patients, 3 underwent endoscopic drainage only, 21 underwent open drainage, and 4 patients underwent a combination of open and endoscopic drainage. The most significant complication seen was persistent decreased visual acuity despite treatment, which was present in 5 patients (6%).
Discussion: Orbital cellulitis remains a potentially sight-threatening infection that requires careful management, preferably by combined ENT and Ophthalmology teams. Surgery is reserved for those patients in whom signs of visual compromise are present initially, or in those who fail to improve with maximal medical management. Currently endoscopic drainage is not the most common surgical approach, however for selected patients it appears a safe comparable alternative.