Recognize serious eye infections early to prevent complications, such as vision loss or orbital abscess. Orbital and preseptal cellulitis can cause redness, eyelid swelling, and even bulging of the eye. As a dual-fellowship trained oculofacial plastic surgeon, Dr. David Isaacs offers expert diagnosis and treatment to ensure timely, targeted care for both adults and children.
Identify Early Signs of Orbital Complications
Orbital and preseptal cellulitis are infections that involve the tissues surrounding the eye. Preseptal cellulitis affects the eyelid and skin in front of the orbital septum, while orbital cellulitis involves structures like the muscles and fat behind the septum. Both require prompt care to prevent complications like abscesses or vision loss. Dr. Isaacs uses advanced diagnostic techniques, such as imaging, to distinguish between them and create tailored treatment plans, ranging from antibiotics to urgent surgical drainage, to ensure optimal recovery.
Preseptal Cellulitis
Preseptal cellulitis, also known as periorbital cellulitis, is an infection that affects the eyelid and surrounding soft tissues located in front of the orbital septum, a natural barrier that separates the eyelid from the deeper structures of the eye socket. It is typically caused by the spread of bacteria through minor trauma (such as insect bites or scratches), infections from nearby structures like the sinuses or tear sac (dacryocystitis), or skin conditions such as impetigo.
Symptoms of Preseptal Cellulitis:
- Redness and swelling of the eyelid
- Warmth and tenderness around the eye
- No vision impairment
- No pain with eye movement
- No bulging of the eye (proptosis)
Dr. Isaacs’ Approach to Treating Preseptal Cellulitis
Dr. David Isaacs carefully evaluates each case to distinguish preseptal cellulitis from more serious orbital infections. He typically initiates treatment with targeted oral antibiotics against common bacteria such as Staphylococcus aureus and Streptococcus pneumoniae. Patients are closely monitored to ensure the infection resolves without spreading. In pediatric cases or more severe presentations, Dr. Isaacs may recommend hospitalization for intravenous antibiotics.
Orbital Cellulitis
Orbital cellulitis is a serious, potentially sight- and life-threatening infection that affects the tissues behind the orbital septum, including the fat and muscles within the eye socket. Unlike preseptal cellulitis, this condition involves deeper orbital structures and can rapidly spread to the brain or optic nerve if left untreated. The most common cause is sinusitis, but it may also result from orbital trauma, post-surgical infections, or systemic infections through the bloodstream.
Dr. Isaacs’ Approach to Treating Orbital Cellulitis
Dr. Isaacs treats orbital cellulitis as a medical emergency, initiating care with immediate hospitalization and intravenous broad-spectrum antibiotics, including coverage for resistant organisms like MRSA.
He orders advanced imaging, such as CT or MRI scans, to assess the extent of the infection and identify any abscesses. If an abscess is present or the infection fails to respond to medical therapy, Dr. Isaacs performs prompt surgical drainage.
Symptoms of Orbital Cellulitis:
- Severe pain, especially with eye movement
- Bulging of the eye (proptosis)
- Restricted or painful eye movements (ophthalmoplegia)
- Vision changes or vision loss
- Fever and general malaise
Pediatric Orbital & Preseptal Cellulitis
Children are more susceptible to both conditions due to anatomical factors like thinner orbital bones and a more robust blood supply, which can facilitate the spread of infection. As a result, even mild infections can progress quickly and require prompt intervention to prevent serious complications such as vision loss, brain abscess, or cavernous sinus thrombosis.
Sinusitis is one of the most common causes of orbital cellulitis in children, so managing sinus infections is essential. Vaccinations against Haemophilus influenzae type b and Streptococcus pneumoniae have significantly reduced the overall incidence, but breakthrough cases still occur. Dr. Isaacs closely monitors pediatric patients with preseptal cellulitis for signs of progression to orbital cellulitis and uses imaging and hospital-based care when needed.
Schedule Your Consultation
David Isaacs, MD, is a dual-fellowship trained oculofacial plastic and reconstructive surgeon with extensive expertise in diagnosing and managing complex infections around the eyes. Known for his meticulous approach and dedication to patient safety, Dr. Isaacs uses advanced imaging and personalized treatments to ensure timely care, especially in urgent cases like orbital cellulitis. If you or your child is experiencing symptoms, schedule a consultation in Beverly Hills today for expert evaluation and treatment.
