What is the Difference Between Orbital and Preseptal Cellulitis?

The main difference between orbital and preseptal cellulitis lies in the location and extent of the infection.

• Orbital cellulitis: This describes the infectious involvement of the tissues posterior to the orbital septum, including the fat and muscle within the bony orbit. It is usually caused by contiguous spread of ethmoid or frontal sinusitis. Symptoms may include decreased ocular motility, proptosis, and decreased visual acuity. Orbital cellulitis can result in more serious complications and is considered a life-threatening emergency.
• Preseptal cellulitis: This characterizes a cellulitis of the tissues localized anterior to the orbital septum. It is commonly caused by contiguous spread from nearby structures, such as the eyelid or face. Symptoms may include eyelid swelling, redness, and pain. Preseptal cellulitis is generally less severe than orbital cellulitis and is more common, particularly in children.

Diagnosis of both preseptal and orbital cellulitis is primarily clinical, with CT or MRI scans sometimes used if orbital cellulitis is suspected. Prompt evaluation by a doctor, including history and physical examination, is crucial for distinguishing between the two types of infection. Immediate referral to an ophthalmologist or an emergency department is recommended for all cases.

Comparative Table: Orbital vs Preseptal Cellulitis

Preseptal and orbital cellulitis are both infections of the soft tissues in the eye socket, but they differ in their location and severity. Here is a table summarizing the differences between the two:

Preseptal cellulitis is more common and typically less severe than orbital cellulitis. It usually occurs due to local trauma, sinusitis, or an insect bite. On the other hand, orbital cellulitis can be more severe and may result from sinusitis, trauma, or recent surgery near the eye. It is crucial to distinguish between these two forms of cellulitis for proper diagnosis and treatment.