Preseptal cellulitis is an infection of the eyelid and the skin around the eyeball. It typically affects children and causes symptoms such as swelling, pain, and redness around the eye.

The condition occurs when bacteria enter the eyelid or surrounding skin. The bacteria infect the area in front of the orbital septum. The orbital septum separates the frontal structures of the eyelid from the back portion, known as the orbit.

Preseptal cellulitis is most common in children under the age of 10 years. However, it can occur at any age.

Preseptal cellulitis may require antibiotic treatment.

Keep reading to learn about the symptoms, causes, and treatments associated with preseptal cellulitis.

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Preseptal cellulitis can cause a range of symptoms, depending on where the inflammation occurs. The symptoms that occur affect the eyelid or the area around one eye.

Some possible symptoms include:

  • swelling
  • redness of the eyelid or the area around it
  • pain
  • tenderness
  • irritability
  • fever
  • tiredness

Preseptal cellulitis usually occurs when germs enter the eyelid area. For example, rubbing or picking at the eye can transfer bacteria into it. Bacteria can also enter the eye from a nearby scratch or bug bite.

The eyes have sinuses around them that consist of air-filled pockets. A fluid that enters these air-filled pockets can lead to sinusitis, which is a sinus infection. Sinusitis can progress into preseptal cellulitis.

According to the College of Optometrists, the Haemophilus influenzae type b (Hib) vaccine can reduce the risk of preseptal and orbital cellulitis in children.

The Centers for Disease Control and Prevention (CDC) recommend the Hib vaccine for all children under 5 years old. The vaccine should also be a consideration for unvaccinated children older than 5 years.

Adults with certain medical conditions or who receive a bone marrow transplant may also benefit from the Hib vaccine.

Other common bacteria that increase the risk of preseptal cellulitis include Staphylococcus aureus, Streptococcus pneumoniae, and Streptococcus pyogenes.

A person who has a stye could also develop preseptal cellulitis. Washing the face with a gentle cleanser or soap each day, removing eye makeup after use, and applying warm compresses around the eyelid can all reduce the risk of styes and preseptal cellulitis.

A doctor will first confirm the diagnosis by checking a person’s medical history and examining the eye. They will determine a treatment depending on how serious the infection is and the person’s age.

The doctor may prescribe oral antibiotics when the cause is an infection from S. aureus or Streptococcus. They may suggest taking the antibiotics for at least 5–7 days. Some people may show signs of improvement within a day or two and may require antibiotic treatment for a shorter duration.

The doctor may also use an X-ray or CT scan to examine more serious infections. Surgery is sometimes necessary to correct issues from serious cases of preseptal cellulitis. Children under 1 year old may also require IV antibiotics in a hospital.

Orbital cellulitis affects the eye and surrounding fatty and muscular structures. The infection occurs behind the orbital septum rather than in front of it.

Both preseptal and orbital cellulitis are more common among children. Over 90% of orbital infections result from underlying sinus issues.

Orbital cellulitis can also potentially lead to vision loss or blindness. Other complications include meningitis, blood clots in the sinuses, and abscesses.

Some common symptoms of orbital cellulitis include:

  • severe swelling and redness of the eyelid
  • blurry vision
  • drooping of the upper eyelid
  • bulging of the eye
  • restricted eye movement
  • pain with eye movement
  • decline in vision
  • deterioration of color vision
  • fever

Treatment for orbital cellulitis requires hospitalization and IV antibiotic treatment.

Blepharitis is a condition that causes inflammation, redness, and itching of the eyelids. It can lead to the formation of small flakes and crust on the eyelashes.

Blepharitis is also the result of bacteria causing infection and inflammation of the eyelid. However, it can also develop from clogged oil glands near the eyelids. It is usually a result of a person’s own skin bacteria.

There are two types of blepharitis: anterior blepharitis and posterior blepharitis. Anterior blepharitis affects the outer edge of the eyelid, and posterior blepharitis affects the inner edge of the eyelid.

The most common symptoms of blepharitis include:

  • a feeling that something is in the eye
  • burning or stinging eyes
  • watery eyes
  • sensitivity to light
  • red eyes or eyelids
  • dry eyes
  • crusty eyelids or eyelashes, particularly after sleeping

There is currently no cure for blepharitis. However, people with blepharitis should cleanse the area around the eyelid with a mild face wash or soap to remove crusts and oil buildups.

A doctor may also suggest warm compresses, artificial tears, prescription eye drops, ointments, or oral medications to reduce the symptoms.

The outlook for people with preseptal cellulitis is good if they receive timely medical attention. Most people will recover from the condition without the need for hospitalization and without experiencing any long-term complications.

Preseptal cellulitis is an infection of the eyelid or soft tissues around it. It causes swelling, redness, and tenderness around the eyelids.

Most people can treat the condition with antibiotics from a doctor. There can be serious complications without treatment, so it is important to contact a doctor when symptoms occur.