Periorbital Cellulitis

ExitCare ImagePeriorbital cellulitis is a common infection that can affect the eyelid and the soft tissues that surround the eyeball. The infection may also affect the structures that produce and drain tears. It does not affect the eyeball itself. Natural tissue barriers usually prevent the spread of this infection to the eyeball and other deeper areas of the eye socket.    


  • Bacterial infection.

  • Long-term (chronic) sinus infections.

  • An object (foreign body) stuck behind the eye.

  • An injury that goes through the eyelid tissues.

  • An injury that causes an infection, such as an insect sting.

  • Fracture of the bone around the eye.

  • Infections which have spread from the eyelid or other structures around the eye.

  • Bite wounds.

  • Inflammation or infection of the lining membranes of the brain (meningitis).

  • An infection in the blood (septicemia).

  • Dental infection (abscess).

  • Viral infection (this is rare).


Symptoms usually come on suddenly.

  • Pain in the eye.

  • Red, hot, and swollen eyelids and possibly cheeks. The swelling is sometimes bad enough that the eyelids cannot open. Some infections make the eyelids look purple.

  • Fever and feeling generally ill.

  • Pain when touching the area around the eye.


Periorbital cellulitis can be diagnosed from an eye exam. In severe cases, your caregiver might suggest:

  • Blood tests.

  • Imaging tests (such as a CT scan) to examine the sinuses and the area around and behind the eyeball.


If your caregiver feels that you do not have any signs of serious infection, treatment may include:

  • Antibiotics.

  • Nasal decongestants to reduce swelling.

  • Referral to a dentist if it is suspected that the infection was caused by a prior tooth infection.

  • Examination every day to make sure the problem is improving.


  • Take your antibiotics as directed. Finish them even if you start to feel better.

  • Some pain is normal with this condition. Take pain medicine as directed by your caregiver. Only take pain medicines approved by your caregiver.

  • It is important to drink fluids. Drink enough water and fluids to keep your urine clear or pale yellow.

  • Do not smoke.

  • Rest and get plenty of sleep.

  • Mild or moderate fevers generally have no long-term effects and often do not require treatment.

  • If your caregiver has given you a follow-up appointment, it is very important to keep that appointment. Your caregiver will need to make sure that the infection is getting better. It is important to check that a more serious infection is not developing.


  • Your eyelids become more painful, red, warm, or swollen.

  • You develop double vision or your vision becomes blurred or worsens in any way.

  • You have trouble moving your eyes.

  • The eye looks like it is popping out (proptosis).

  • You develop a severe headache, severe neck pain, or neck stiffness.

  • You develop repeated vomiting.

  • You have a fever or persistent symptoms for more than 72 hours.

  • You have a fever and your symptoms suddenly get worse.


  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.