10 terms
Orbital Cellulitis
5 Ps
-Proptosis
-Pain with eye movement
-Palpation, increased resistance to retroPulsion
-Problems with cranial nerves
-Protrusion on conjunctiva, chemosis
-Pain with eye movement
-Palpation, increased resistance to retroPulsion
-Problems with cranial nerves
-Protrusion on conjunctiva, chemosis
Pre-orbital/pre-septal cellulitis
-infection and inflammation confined to the eyelids and periorbital structures anterior to the orbital septum
-globe usually not involved
-no pain with eye movement
-no conjunctival chemosis
-not an "orbital process"
-globe usually not involved
-no pain with eye movement
-no conjunctival chemosis
-not an "orbital process"
clinical features of orbital disease
-proptosis, conjunctival injection, conjunctival chemosis, motility limitation and visual changes
extension from peri-orbital structures
-paranasal sinuses, face, eyelids, dacrocystitis, dental infection, intracranial source
exogenous sources
-trauma, consider and rule out foreign body
-post-surgical, from orbital or peri-orbital surgery
-post-surgical, from orbital or peri-orbital surgery
endogenous
-bacteremia with septic emboli
intraorbital
-endophthalmitis, dacryoadenitis
microbiology
-gram positive cocci
-h flu
-amaerobes
-children, mostly have single organism
-h flu
-amaerobes
-children, mostly have single organism
remember fungus!
-seen in immunocompromised patient, metabolic acidosis
-diabetes
-diabetes
post septal/orbital cellulitis
-inflammation and infection involving the structures posterior to the orbital septum
-90% spread from paranasal sinuses
-often have fever
-orbital process- proptosis, injection and chemosis, motility and vision abnormalities
-90% spread from paranasal sinuses
-often have fever
-orbital process- proptosis, injection and chemosis, motility and vision abnormalities