Issue 7/2024
Ivanova, А., Vassileva, Р.
Specialized Eye Hospital “Acad. Pashev” – Sofia
Periorbital inflammations are two types – preseptal and postseptal. They are not commonly encountered in daily practice and differential diagnosis can be challenging. Preseptal cellulitis is an infection of the tissues infront of the orbital septum, while orbital cellulitis affects the fatty tissue and muscles behind the septum. In bothcondition the eyeball in not affected!
Preseptal cellulitis occurs as a result of superficial infection of the skin and periorbital tissues. Orbital cellulitis in 80% of cases occurs due to acute sinusitis in adjacent paranasal sinuses, an odontogenic cause or hematogenous dissemination (only in newborns).
Preseptal cellulitis can spread over a larger area and acquire the character of necrotizing fasciitis. Orbital cellulitis carries the risk of developing inflammation at the apex of the orbit (paresis of the oculomotor muscles, ptosis of the eyelids, corneal anesthesia, blindness), orbital compartment syndromeor intracranial spread of the infection – thrombosis of the cavernous sinus.
An interdisciplinary approach and good communication between specialists from different specialties (pediatricians, ophthalmologists, ENT specialists) are essential for the treatment of periorbital inflammations. Treatment of uncomplicated cases is primarily with antibiotics. Surgical treatment isappropriatein almost all cases of intracranial involvement, a poor result of conservative treatment or the presence of an abscess >10mm.
Key words: periorbital inflammations, differential diagnosis and classification, clinical picture
Аddress for correspondation:
Ivanova, A.
Specialized Eye Hospital for Active
Treatment „Acad. Pashev“,
51, “Em. Vaskidovich”, Str.
1517, Sofia
e-mail: anita_ivanova12@abv.bg