A red or painful eye is a common presentation in the emergency department, and the rapid identification and management of potentially sight-threatening causes is critical.
- Periorbital and Orbital Cellulitis can be difficult to distinguish from initially. Know that both have a good chance of improving with IV antibiotics.
- Not every child with preseptal/periorbital cellulitis requires a CT in the ED to rule-out orbital involvement.
- If there is no proptosis and normal eye movement, IV antibiotics may be sufficient.
- Hospitalization for close reassessments and eye exam can help determine if CT is eventually required.
- Not every child with CT proven orbital cellulitis requires surgery! So don’t be mad when the ENT doctor recommends that the child is admitted for IV antibiotics to the Pediatric Service.
- Bilateral is Bad! Think Cavernous Sinus Thrombosis!