Overview

• Preseptal (Periorbital) Cellulitis
  • Infection of the soft tissues anterior to the orbital septum (eyelids, skin, subcutaneous tissue).
  • Due to spread of infection from surrounding structures (typically after sinusitis or other respiratory tract infections).
  • Sx → red, swollen, painful eye of acute onset. (Any orbital signs indicates orbital cellulitis).
  • Mx → refer all cases to secondary care for assessment. Usually given oral co-amoxiclav.
• Orbital Cellulitis
  • Infection affecting the fat and muscles posterior to the orbital septum. MUCH MORE SERIOUS.
  • Risk Factors → childhood, previous sinus infection, lack of haemophilus influenzae type b vaccination.
  • Sx → redness around eye, severe ocular pain, visual disturbance, proptosis, opthalmoplegia (pain on eye movements), proptosis.
  • Ix → CT orbit with contrast.
  • Mx → hospital admission for IV antibiotics.
• Retinoblastoma
  • Autosomal dominant.
  • Sx → absence of red-reflex, strabismus, visual problems.
• Strabismus
  • Condition of having a squint.
  • Common up to 3 months of age, with most common cause being refractive error.
  • If >3 months with persistent strabismus, should be referred for specialist ophtalmological opinion.
• Retinopathy of Prematurity → over-oxygenation in premature babies can cause retinal vessel proliferation which can lead to a loss of the red reflex and neovascularisation.
• Ophthalmia Neonatorum
  • <48 Hrs of Life → gonococcus. (Tx → IV cefotaxime)
  • 1-2 Wks of Life → chlamydia trachomatis. (Tx → oral erythromycin for 2 weeks)
  • Referral for same-day opthalmology / paediatric assessment.

Making Diagnosis

Clinical Features

Investigations

Management Plan

Complications →

Prognosis →