Preseptal cellulitis

Patients with preseptal cellulitis presents with an acutely painful, swollen eyelid. It is because of the pronounced edema, the patient might not be able to open his or her eyes. However, there is being no disturbances in visual acuity or ocular motility, nor any signs of proptosis. There might be a concurrent history of sinus infection or congestion, penetrating trauma to the eyelid, or dental infection. In most of the cases, the patient will be systemically well and afebrile. Preseptal cellulitis is a widespread infection of the eyelid and periorbital soft tissues characterized by acute eyelid erythema and edema. This bacterial infection generally results from local spread of adjacent upper respiratory tract infection, external ocular infection, or following trauma to the eyelids. Preseptal cellulitis tends to be a less serious disease than post-septal or orbital cellulitis, which can present in a similar manner. Orbital cellulitis has a higher morbidity, needs aggressive treatment, and may require surgical intervention, whereas preseptal cellulitis usually is managed medically. Delineation of the exact location of inflammation is essential for proper diagnosis and treatment.

Symptoms of the preseptal cellulitis

The eyelid is separated into preseptal and post-septal areas by the orbital septum, which protects the spread of infection to the orbit and central nervous system. Preseptal cellulitis is basically a bacterial infection of the eyelid anterior to the orbital septum. The routes of infection comprise of direct inoculation from trauma, or spread of infection from the neighboring ethmoid sinus or teeth. The most commonly encountered organisms comprise of Staphylococcus aureus, Streptococcus pyogenes and Streptococcus pneumoniae. If a human or animal bite wound is the source, suspect anaerobic bacteria like that of Peptostreptococcus and Bacteroides. If the infection spreads posterior to the orbital septum, it might result in a post-septal cellulitis, with associated vision loss, ocular motility restrictions and proptosis. Patients with orbital cellulitis are procedure wise ill and febrile.

Causes of the preseptal cellulitis

Periorbital inflammation is divided by location and severity. One of the primary anatomic landmarks in determining the location of disease is the orbital septum. The orbital septum is a thin membrane, which originates from the orbital periosteum and inserts into the anterior surfaces of the tarsal plates of the eyelids. The septum divides the superficial eyelid from the deeper orbital structures, and it forms a barrier that prevents infection in the eyelid from extending into the orbit. Preseptal cellulitis varies from orbital cellulitis in that it is confined to the soft tissues that are anterior to the orbital septum. Preseptal cellulitis might spread posterior to the septum and progress to form subperiosteal and orbital abscesses

Recommended Reading:

1. Orbital cellulitis - The septum is the pre-stage of a cellulitis. The orbital septum, thus, is a layer of fascia extending vertically from...
2. Periorbital Cellulitis: an introduction and description - Periorbital Cellulitis can be defined as an inflammation and infection of the eyelid and the skin surrounding the eye. Periorbital...
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4. Cellulitis in children - A brief idea about cellulitis Cellulitis is a bacterial infection which affects the skin and the tissues underlying it. It...
5. Cellulitis of the eye - The causative agent: The term cellulitis is the infection of the underlining and the adjoining tissues in the eye region....