Cellulitis
What is cellulitis?
Cellulitis is when your skin gets infected and swells up.
What is the orbital septum?
The orbital septum is a strong wall inside your eyelid. It keeps the skin of your eyelid separate from the deeper parts around your eye.
What is preseptal cellulitis?
Preseptal cellulitis is an infection that makes your eyelid skin red and puffy. It stays in front of the wall in your eyelid. It does not go deeper into your eye area.
What is orbital cellulitis?
Orbital cellulitis is an infection that goes deeper into your eye area, past the wall in your eyelid. Your eye area connects to your nose and sinuses. If you have a sinus infection, it can spread to your eye area. Orbital cellulitis is more serious than preseptal cellulitis.
What are the differences in the signs and symptoms of preseptal and orbital cellulitis?
Sometimes it is hard to tell these two types apart, even for doctors. Both make your eyelids look red and puffy. But with preseptal cellulitis, your eyes move fine and stay in the right place. With orbital cellulitis, your eyes might not move well, and one eye might stick out more than normal. You might not see as well, colors might look different, and your pupil might not work right.
Fig. 1: Preseptal cellulitis caused by methicillin-resistant staphylococcus aureus (MRSA)
What causes preseptal cellulitis?
Your eyelid gets red and puffy because of infection or swelling. Common causes are:
- Sinus infection
- Infection that spreads from nearby areas (like a bump on your eyelid or after eye surgery)
- Infection that spreads through your blood
- Bug bites
- Allergic reactions
- Cuts on your skin
HOW IS PRESEPTAL CELLULITIS DIAGNOSED? HOW DO YOU TELL THE DIFFERENCE BETWEEN PRESEPTAL AND ORBITAL CELLULITIS?
Your doctor will ask about your health and check your eyes. They might do blood tests to look for infection. You might need special pictures taken (like a CT scan or MRI) to see if the infection has spread deeper into your eye area.
How is preseptal cellulitis treated?
If doctors think bacteria caused your infection, they will give you antibiotics. You might take pills or get shots. Sometimes you need antibiotics through an IV tube in your arm. Some children need to stay in the hospital so doctors can watch them. Cool cloths on your eye and allergy medicine can help with swelling from allergies or bug bites.
What are the complications of preseptal cellulitis?
Preseptal cellulitis usually gets better with treatment. Most people get completely well. But sometimes the infection can spread past the wall in your eyelid and cause problems deeper in your eye area.
What causes orbital cellulitis?
Some causes of orbital cellulitis are:
- Sinus infection (this happens most often)
- Injury or something stuck in your eye area
- Recent surgery around your eye
- Infection from your blood
- Tooth infection
HOW IS ORBITAL CELLULITIS TREATED?
Treatment usually means staying in the hospital so doctors can watch you closely. You will get antibiotics through an IV tube in your arm. You might need surgery to drain the infection if you don't get better or if you get worse. Doctors will watch carefully to make sure you don't lose your sight.
What are the complications of orbital cellulitis?
If the infection spreads to other areas, it can become very serious. If it spreads to your brain, it can cause a pocket of infection in your brain, infection around your brain, or too much pressure in your brain. Infection around the nerve to your eye or your eye muscles can cause you to go blind or make your eyes not line up right. These serious problems often need emergency care or surgery because they can be life-threatening. But with the right treatment, orbital cellulitis usually gets better and people get completely well.
SUMMARY FOR THE PATIENT OR CAREGIVER:
Cellulitis is an infection that makes the skin around your eyelid or eye area red and swollen. There are two types: preseptal cellulitis affects only your eyelid, and orbital cellulitis affects deeper parts around your eye. Both types make your eyelids red and puffy, but orbital cellulitis is more serious. It can cause problems moving your eyes, trouble seeing, brain infections, or your eye sticking out too much. Treatment for both types usually includes antibiotics, and sometimes you need to stay in the hospital. In serious cases, you might need surgery. With the right treatment, most people get completely better.
Updated: 06/2025