-Proptosis -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"
clinical features of orbital disease
-proptosis, conjunctival injection, conjunctival chemosis, motility limitation and visual changes
-trauma, consider and rule out foreign body -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
remember fungus!
-seen in immunocompromised patient, metabolic acidosis -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
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