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Orbital Cellulitis: Swelling Around the Eye Can Be an Emergency

Quick answer

Orbital cellulitis is an infection in the deeper tissues around the eye and may follow a sinus infection. Eyelid swelling with fever, painful eye movement, bulging or reduced vision needs emergency care now. Do not wait for a routine visit or start steroids or antibiotics on your own.

How is it different from a swollen eyelid?

Preseptal cellulitis affects the skin and tissues in front of the orbital septum. Orbital cellulitis affects deeper tissues behind it and can impair eye movement, the nerve or vision. An examination is needed to distinguish them; a phone photo cannot show the depth of infection.

Signs of a deeper infection

There may be marked swelling and redness, fever or feeling unwell, a bulging eye, pain or restricted movement, double vision or reduced sight. Children may not describe the change clearly. Pain with eye movement or reduced vision is a key reason not to wait.

How is it assessed?

The clinician checks vision, pupils, eye movement and overall health. CT or MRI may be needed when the infection may have spread or an abscess is suspected. An ophthalmologist may work with an ear, nose and throat or pediatric team. Testing depends on severity and findings.

Treatment often takes place in hospital

Treatment may require intravenous antibiotics and close monitoring, and sometimes surgery to drain an abscess or treat the sinuses. This is not a condition to manage at home; delay can threaten sight and general health. Follow the care team's plan even if swelling first improves.

What should you do now?

Go to emergency care for these signs, and do not drive if vision is affected. Bring a medicine and allergy list and mention any recent sinus infection or injury. Do not press on the swelling or use old drops or hot compresses without advice.

Frequently asked questions

Is orbital cellulitis contagious?

It is not usually spread by simply looking at or being near someone, but the infection causing it needs urgent treatment.

Can it be treated with drops alone?

Drops are usually not enough for a deep infection. Hospital assessment and intravenous treatment may be needed.

Can a sinus infection cause swelling around the eye?

A sinus infection can spread to tissues around the eye. Painful swelling with fever or limited eye movement needs emergency care.

Can I wait if swelling seems mild?

Do not wait if there is pain on eye movement, fever, bulging or reduced vision. A clinician must assess how deep the infection is.

This article is for education and does not replace an eye examination. Sudden vision change, severe pain, an eye injury or another emergency sign needs urgent assessment.