Lid/Orbit
Preseptal Cellulitis
Also known as: periorbital cellulitis, pre-septal cellulitis, preseptal infection, eyelid cellulitis
Filed as: Urgent
Source-cited from the record's own evidence list. Clinical content programme led by Dr Ankit Mathur, PhD, Grad Cert Ocu Thera, B.S. Optom. How the clinical content is governed
Clinical decision support only
OptoGuide™ supports professional judgement and does not diagnose or replace clinician responsibility.
Overview
Periorbital soft tissue infection anterior to the orbital septum. It causes eyelid/periorbital swelling and redness but should not affect vision, pupils, or extraocular motility; orbital cellulitis must be excluded.
Recognition
Symptoms: what patients report
- Unilateral eyelid or periorbital swelling, redness, warmth, and tenderness.
- Possible watery eye or mild conjunctival injection.
- Often follows sinusitis/URTI, hordeolum or adjacent lid infection, insect bite, minor trauma, or occurs in a child.
Signs: what the examination shows
- Warm diffuse eyelid or periorbital oedema and erythema.
- Visual acuity, pupils, and extraocular motility are normal in uncomplicated preseptal disease.
- No diplopia, proptosis, or pain with eye movement.
- May have a local source such as hordeolum, skin break, insect bite, or adjacent infection.
What OptoGuide™ covers for preseptal cellulitis
- Pattern reasoning: what this combination of findings points to, and its differentiators
- Don't-miss risks and escalation triggers
- Management tiers with linked Australian therapeutics
- Referral urgency, specialty, and letter drafting
Sources
- Preseptal and orbital cellulitis — College of Optometrists Clinical Management Guideline
- Anterior Eye Disease and Therapeutics A-Z (Bruce & Loughnan) — standard reference text
- Case 12-2021: A 78-Year-Old Man with a Rash on the Scalp and Face. Yoon MK, Kelly HR, Freitag SK, et al. The New England Journal of Medicine. 2021;384(16):1553-1562.
- Eye of the Beholder. MacFarlane L, Osman N, Ritter S, Miller AL, Loscalzo J. The New England Journal of Medicine. 2016;374(18):1774-9.
- Pediatric Preseptal and Orbital Cellulitis: A Comparative Study of Clinical, Radiologic, and Laboratory Features. Şahin A, Tanriverdi Kaymaz C, Kara Aksay A, et al. The Pediatric Infectious Disease Journal. 2025;:0000645
Standard texts: Kanski's Clinical Ophthalmology: A Systematic Approach, The Wills Eye Manual, Oxford Handbook of Ophthalmology, Oxford American Handbook of Ophthalmology, Signs in Ophthalmology: Causes & Differential Diagnosis.