Cellulitis of the orbit is the most common cause of proptosis in children and also frequently arises in the elderly and the immunocompromised.
It arises from extension of infection from the nasal sinuses or the skin of the face although in children, there may be haematogenous spread from a more distant site. The organisms most frequently involved are those most common in the sinuses - Haemophilus influenzae, Streptococcus pneumoniae, and staphylococci.
The condition is characterised by acute swelling of the orbital tissues, proptosis, oedema and limited eye movement. The condition may be complicated by cavernous sinus thrombosis as indicated by neurological signs, visual loss, muscle paresis and papilloedema. Erosion of orbital bones may result in brain abscess and meningitis.
The condition must be differentiated from rhabdomyosarcoma, pseudotumour, and Graves ophthalmology.
Last reviewed 01/2018