Orbital and Preseptal Cellulitis: Epidemiology, Etiology, and Management

Considering the little evidence regarding peri-orbital infections, this study was aimed to obtain information about the epidemiology, etiology, and management of orbital infections.

In this retrospective investigation, all patients with peri-orbital infection who were hospitalized in a tertiary ophthalmologic center in AL-Zahra hospital, Isfahan, Iran from 2008 up to 2018 were identified. Documented data and radiographic images were extracted. The data regarding epidemiology, etiology and disease course was analyzed.

Sixty nine patients (35 males, 34 females) with the age range between 3 months to 85 years were included. Preseptal cellulitis was recorded in 53 cases (76.8%) and orbital cellulitis was seen in 16 cases (23.2%), and the proportion of preseptal to orbital was 3.3 to 1. The mean duration of hospitalization in patients with preseptal cellulitis was 6.38 ±, 4.59 days and in patients with orbital cellulitis was 12.44 ±, 9.63 days. Most patients with preseptal cellulitis were treated by medication therapy (71.7%), while the orbital cellulitis were often treated by surgical procedures (56.2%). Sinusitis was the main cause of both preseptal and orbital cellulitis in all age groups, except infants under 1 year, which dacryocystitis was identified as primary factor.

The prevalence of peri-orbital infection was higher in children. The prevalence ratio of preseptal to orbital cellulitis was 3.3:1. The main etiologic factor was sinusitis. There is no agreement for the treatment modalities of peri-orbital infections and the timing of surgical intervention. Continuous evaluation of treatment course, both clinically and radiographically is important. Reassessment is recommended when improvement is not seen after 6-7 days of treatment.