Orbital Cellulitis in Children

Medically reviewed by Drugs.com. Last updated on Feb 9, 2025.

What is orbital cellulitis?

Orbital cellulitis is a bacterial infection of your child's eye and the tissue around his or her eye. The nerves that go to the eye are also infected. Orbital cellulitis is a serious condition that can lead to blindness.

What causes orbital cellulitis?

A sinus infection
Infection of the teeth, ear, or face
Trauma to the eye
An animal or insect bite
A foreign object

What are the signs and symptoms of orbital cellulitis?

Red, swollen, painful eye and eyelid
Bulging eyeball
Painful eye movements
Trouble moving the eye
Blurred, double, or loss of vision
A fever

How is orbital cellulitis diagnosed?

Your child's healthcare provider will check your child's vision, eye movement, and eye pressure. Your child may also need any of the following:

Blood tests may show what bacteria is causing your child's infection.
A sample of fluid or tissue from your child's eye or sinuses may show the cause of the infection. A sample may also show what areas are infected and what antibiotic would work best for treatment.
A CT or MRI may show an abscess, rupture (tear), a blood clot, or other problems. Your child may be given contrast liquid to help his or her eye show up better in the pictures. Tell the healthcare provider if your child has ever had an allergic reaction to contrast liquid. Do not let your child enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if your child has any metal in or on his or her body.

How is orbital cellulitis treated?

Your child will need to stay in the hospital to treat orbital cellulitis. He or she may need any of the following:

Medicines:
- Antibiotics treat the bacterial infection. Antibiotics are given through an IV.
- Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to give your child and how often to give it. Follow directions. Read the labels of all other medicines your child uses to see if they also contain acetaminophen, or ask your child's doctor or pharmacist. Acetaminophen can cause liver damage if not taken correctly.
- NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him or her. Always read the medicine label and follow directions. Do not give these medicines to children younger than 6 months without direction from a healthcare provider.
- Steroids help decrease redness and swelling of your child's eye.
Surgery may be needed if your child's infection is severe and his or her vision is damaged. Surgery is also needed if an abscess or nasal sinus needs to be drained, or to remove a foreign object.

How can I manage my child's symptoms?

Remind your child to not rub or scratch his or her eye. This can increase your child's risk for spreading the infection.
Place a cool, damp cloth on your child's eye. Use clean cloths and clean water. You can do this as often as you need to. Cool, damp cloths may help decrease pain.
Have your child wash his or her hands often. Make sure he or she washes with soap and water after using the bathroom or sneezing. He or she also needs to wash his or her hands before eating. Use lotion to prevent dry, cracked skin.

How can another eye infection be prevented?

Have your child wear proper safety equipment. Protect your child's face from injury during sports and other activities.
Keep wounds clean and dry. Clean wounds on your child's face with soap and water. Cover wounds with a dry bandage if needed.

Call your local emergency number (911 in the US) if:

Your child seems confused or more sleepy than usual.
Your child complains of a headache and is vomiting.
Your child complains of a stiff neck.

When should I seek immediate care?

You see red streaks coming from your child's infected area.
Your child loses vision in his or her infected eye.
Your child cannot close his or her eye due to swelling.

When should I call my child's doctor?

Your child has a fever higher than 101.5°F (38.6°C) and chills.
The red, warm, swollen area gets larger.
Your child's fever or pain does not go away or gets worse.
You have questions or concerns about your child's condition or care.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's healthcare providers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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