What is the Difference Between Orbital and Preseptal Cellulitis

The key difference between orbital and preseptal cellulitis is that orbital cellulitis is an infection in the contents of the orbit, including fat and ocular muscles, while preseptal cellulitis is an infection in the anterior portion of the eyelid that does not involve the orbit or other ocular structures.

Cellulitis is a bacterial infection that occurs in the eyes. There are two different types of cellulitis that can affect the eyes: orbital and preseptal. Orbital cellulitis is a serious condition, and it needs to be treated more aggressively and immediately than preseptal cellulitis. Orbital cellulitis is most common in children younger than age 7, whereas preseptal cellulitis. Cellulitis usually happens in younger children under the age of 10 years.

CONTENTS

1. Overview and Key Difference
2. What is Orbital Cellulitis
3. What is Preseptal Cellulitis
4. Similarities – Orbital and Preseptal Cellulitis
5. Orbital vs. Preseptal Cellulitis in Tabular Form
6. Summary – Orbital vs. Preseptal Cellulitis

What is Orbital Cellulitis?

Orbital cellulitis is a serious bacterial eye infection. These bacterial species include Staphylococcus aureus, Streptococci species, and non-spore-forming anaerobes such as Aeromonas hydrophila, Eikenella corrode, and Pseudomonas aeruginosa. It can affect anyone. However, it is most common in kids younger than age 7. Orbital cellulitis is a serious infection that involves muscles and fat located within the orbit of the eye. If not treated properly, it can spread to other parts of the body as well.

The symptoms of orbital cellulitis may include swelling and redness of the eyelid and skin around the eye, bulging of eyes known as proptosis, trouble seeing or double vision, and pain or difficulties in eye movement. The risk factors for this condition include sinus infection that spread, infections in other parts of the body, which include the face, mouth, tear ducts or ears that spread, eye injuries, and traumas around the eye.

Orbital cellulitis can be diagnosed through eye examination, blood test, CT scan, and MRI scan. Furthermore, orbital cellulitis is usually treated with antibiotics. If the infection causes an abscess, surgery may be needed to drain it.

What is Preseptal Cellulitis?

Preseptal cellulitis is an infection of the anterior portion of the eyelid that does not involve the orbit or other ocular structures. Preseptal cellulitis is most common in children under the age of 10 years. Preseptal cellulitis usually has a few symptoms, such as eye pain, eyelid erythema, and inflammation only anterior to the orbital septum. The spread of an infection of the face or eyelid by species such as Staphylococcus and Streptococcus species, viruses, fungi, helminths, an infected insect or animal bite, a hordeolum, or sinusitis causes preseptal cellulitis. The risk factors for this condition include sinusitis, dacryocystitis, external ocular infection, and trauma to the eyelids.

Preseptal cellulitis can be diagnosed through physical examination, complete blood count to document leukocytosis, CT scan, cultures of the eyelid wound, and lymph node biopsy. Furthermore, preseptal cellulitis is treated through oral or intravenous antiviral therapy, antiviral medications, and mebendazole, albendazole, piperazine, and praziquantel helminth infections.

What are the Similarities Between Orbital and Preseptal Cellulitis?

• Orbital and preseptal cellulitis are two different cellulitis that affect the eye.
• Bacterial infections can cause both.
• Both can have similar symptoms, such as eye pain, swelling, redness, etc.
• They can be diagnosed through eye examination.
• They can be treated through specific medications such as antibiotics.

What is the Difference Between Orbital and Preseptal Cellulitis?

Orbital cellulitis is an infection of the contents of the orbit, which include fat and ocular muscles, while preseptal cellulitis is an infection of the anterior portion of the eyelid that does not involve the orbit or other ocular structures. Thus, this is the key difference between orbital and preseptal cellulitis. Furthermore, orbital cellulitis is most common in children younger than age 7, while preseptal cellulitis is most common in children under the age of 10 years.

The infographic below presents the differences between orbital and preseptal cellulitis in tabular form for side-by-side comparison.

Summary – Orbital vs. Preseptal Cellulitis

Cellulitis of the eye is an infection and inflammation of the skin and tissues around the eye. It is of two types: orbital and preseptal cellulitis. Cellulitis of the eye sometimes can be very serious. Orbital cellulitis is a serious bacterial eye infection that affects the muscle and fat located within the orbit of the eye, while preseptal cellulitis is a less serious infection caused by different infectious agents such as bacteria, viruses, fungi, helminths, etc., that affects the anterior portion of the eyelid which is not involving the orbit or other ocular structures. So, this summarizes the difference between orbital and preseptal cellulitis.

Reference:

1. Anna G Gushchin, MD. “Orbital Cellulitis.” Medscape.
2. Allen, Richard C. “Preseptal and Orbital Cellulitis – Eye Disorders.” MSD Manual Professional Edition, MSD Manuals.

Image Courtesy:

1. “Preseptal Cellulitis” By Tripp (CC BY 2.0) via Flickr
2. “Orbital cellulitis” By Jonathan Trobe, M.D. – University of Michigan Kellogg Eye Center – The Eyes Have It (CC BY 3.0) via Commons Wikimedia