Periorbital swelling - Revision history

Danbot: Add verified PubMed references (PMIDs 29248536, 29859573)

2026-03-22T10:53:08Z

Add verified PubMed references (PMIDs 29248536, 29859573)

← Revisión anterior		Revisión del 10:53 22 mar 2026
Línea 2:		Línea 2:
	[[File:Orbital septum slide - final big gallery.jpeg\|thumb\|Periorbital anatomy.]]		[[File:Orbital septum slide - final big gallery.jpeg\|thumb\|Periorbital anatomy.]]
	[[File:Gray896.png\|thumb\|Anterior view of the right eye, with lacrimal duct shown medial.]]		[[File:Gray896.png\|thumb\|Anterior view of the right eye, with lacrimal duct shown medial.]]
	*This page describes a general approach to the complaint of periorbital swelling		*This page describes a general approach to the complaint of periorbital swelling<ref>Tsirouki T, et al. Orbital cellulitis. Surv Ophthalmol. 2018 Jul-Aug;63(4):534-553. PMID 29248536</ref><ref>Wong SJ, Levi J. Management of pediatric orbital cellulitis: A systematic review. Int J Pediatr Otorhinolaryngol. 2018 Jul;110:123-129. PMID 29859573</ref>
	*The critical EM distinction is preseptal (periorbital) cellulitis vs. orbital cellulitis		*The critical EM distinction is preseptal (periorbital) cellulitis vs. orbital cellulitis
	**The orbital septum is the key anatomic landmark separating the two		**The orbital septum is the key anatomic landmark separating the two

Danbot: Strip excess bold

2026-03-22T09:35:56Z

Strip excess bold

Danbot: Expanded with EM-focused content: preseptal vs orbital cellulitis distinction, red flags, evaluation, management by etiology, disposition

2026-03-20T23:47:32Z

Expanded with EM-focused content: preseptal vs orbital cellulitis distinction, red flags, evaluation, management by etiology, disposition

Show changes

Rossdonaldson1 at 20:39, 4 February 2026

2026-02-04T20:39:33Z

← Revisión anterior		Revisión del 20:39 4 feb 2026
Línea 3:		Línea 3:
	[[File:Gray896.png\|thumb\|Anterior view of the right eye, with lacramal duct shown medial.]]		[[File:Gray896.png\|thumb\|Anterior view of the right eye, with lacramal duct shown medial.]]
	[[File:Gray894.png\|thumb\|The tarsi and their ligaments. Right eye; anterior view.]]		[[File:Gray894.png\|thumb\|The tarsi and their ligaments. Right eye; anterior view.]]
	[[File:eyelid glands.png\|thumb]]		[[File:eyelid glands.png\|thumb\|Eyelid cros-sectional anatomy]]
	[[File:Tear system.png\|thumb\|Right eye lacrimal system consisting of: of lacrimal gland (a), punctums (b,e), canalicules (c,f), lacrimal sac (g,d).]]		[[File:Tear system.png\|thumb\|Right eye lacrimal system consisting of: of lacrimal gland (a), punctums (b,e), canalicules (c,f), lacrimal sac (g,d).]]
	*This page describes a general approach to the complaint of periorbital swelling		*This page describes a general approach to the complaint of periorbital swelling

Rossdonaldson1: /* Background */

2026-02-04T17:24:51Z

Background

← Revisión anterior		Revisión del 17:24 4 feb 2026
Línea 5:		Línea 5:
	[[File:eyelid glands.png\|thumb]]		[[File:eyelid glands.png\|thumb]]
	[[File:Tear system.png\|thumb\|Right eye lacrimal system consisting of: of lacrimal gland (a), punctums (b,e), canalicules (c,f), lacrimal sac (g,d).]]		[[File:Tear system.png\|thumb\|Right eye lacrimal system consisting of: of lacrimal gland (a), punctums (b,e), canalicules (c,f), lacrimal sac (g,d).]]
			*This page describes a general approach to the complaint of periorbital swelling

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: /* Background */

2024-10-23T22:33:39Z

Background

← Revisión anterior		Revisión del 22:33 23 oct 2024
Línea 1:		Línea 1:
	==Background==		==Background==
			[[File:Orbital septum slide - final big gallery.jpeg\|thumb\|Periorbital anatomy.]]
	[[File:Gray896.png\|thumb\|Anterior view of the right eye, with lacramal duct shown medial.]]		[[File:Gray896.png\|thumb\|Anterior view of the right eye, with lacramal duct shown medial.]]
	[[File:Gray894.png\|thumb\|The tarsi and their ligaments. Right eye; anterior view.]]		[[File:Gray894.png\|thumb\|The tarsi and their ligaments. Right eye; anterior view.]]

Rossdonaldson1 at 22:16, 23 October 2024

2024-10-23T22:16:16Z

← Revisión anterior		Revisión del 22:16 23 oct 2024
Línea 4:		Línea 4:
	[[File:eyelid glands.png\|thumb]]		[[File:eyelid glands.png\|thumb]]
	[[File:Tear system.png\|thumb\|Right eye lacrimal system consisting of: of lacrimal gland (a), punctums (b,e), canalicules (c,f), lacrimal sac (g,d).]]		[[File:Tear system.png\|thumb\|Right eye lacrimal system consisting of: of lacrimal gland (a), punctums (b,e), canalicules (c,f), lacrimal sac (g,d).]]


	==Clinical Features==		==Clinical Features==

Rossdonaldson1 at 22:15, 23 October 2024

2024-10-23T22:15:16Z

← Revisión anterior		Revisión del 22:15 23 oct 2024
Línea 3:		Línea 3:
	[[File:Gray894.png\|thumb\|The tarsi and their ligaments. Right eye; anterior view.]]		[[File:Gray894.png\|thumb\|The tarsi and their ligaments. Right eye; anterior view.]]
	[[File:eyelid glands.png\|thumb]]		[[File:eyelid glands.png\|thumb]]
			[[File:Tear system.png\|thumb\|Right eye lacrimal system consisting of: of lacrimal gland (a), punctums (b,e), canalicules (c,f), lacrimal sac (g,d).]]

	~~[[File:Tear system.png\|thumb\|Right eye lacrimal system consisting of: of lacrimal gland (a), punctums (b,e), canalicules (c,f), lacrimal sac (g,d).]]~~
	~~[[File:eyelid glands.png\|thumb]]~~

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: /* See Also */

2024-10-23T22:14:12Z

Rossdonaldson1: /* Background */

2024-10-23T21:52:04Z

Background

← Revisión anterior		Revisión del 21:52 23 oct 2024
Línea 1:		Línea 1:
	==Background==		==Background==
			[[File:Gray896.png\|thumb\|Anterior view of the right eye, with lacramal duct shown medial.]]
			[[File:Gray894.png\|thumb\|The tarsi and their ligaments. Right eye; anterior view.]]
			[[File:eyelid glands.png\|thumb]]

	[[File:Tear system.png\|thumb\|Right eye lacrimal system consisting of: of lacrimal gland (a), punctums (b,e), canalicules (c,f), lacrimal sac (g,d).]]		[[File:Tear system.png\|thumb\|Right eye lacrimal system consisting of: of lacrimal gland (a), punctums (b,e), canalicules (c,f), lacrimal sac (g,d).]]
	[[File:eyelid glands.png\|thumb]]		[[File:eyelid glands.png\|thumb]]

← Revisión anterior		Revisión del 20:39 4 feb 2026
Línea 3:		Línea 3:
	[[File:Gray896.png\|thumb\|Anterior view of the right eye, with lacramal duct shown medial.]]		[[File:Gray896.png\|thumb\|Anterior view of the right eye, with lacramal duct shown medial.]]
	[[File:Gray894.png\|thumb\|The tarsi and their ligaments. Right eye; anterior view.]]		[[File:Gray894.png\|thumb\|The tarsi and their ligaments. Right eye; anterior view.]]
	[[File:eyelid glands.png\|thumb]]		[[File:eyelid glands.png\|thumb\|Eyelid cros-sectional anatomy]]
	[[File:Tear system.png\|thumb\|Right eye lacrimal system consisting of: of lacrimal gland (a), punctums (b,e), canalicules (c,f), lacrimal sac (g,d).]]		[[File:Tear system.png\|thumb\|Right eye lacrimal system consisting of: of lacrimal gland (a), punctums (b,e), canalicules (c,f), lacrimal sac (g,d).]]
	*This page describes a general approach to the complaint of periorbital swelling		*This page describes a general approach to the complaint of periorbital swelling

← Revisión anterior		Revisión del 22:15 23 oct 2024
Línea 3:		Línea 3:
	[[File:Gray894.png\|thumb\|The tarsi and their ligaments. Right eye; anterior view.]]		[[File:Gray894.png\|thumb\|The tarsi and their ligaments. Right eye; anterior view.]]
	[[File:eyelid glands.png\|thumb]]		[[File:eyelid glands.png\|thumb]]
			[[File:Tear system.png\|thumb\|Right eye lacrimal system consisting of: of lacrimal gland (a), punctums (b,e), canalicules (c,f), lacrimal sac (g,d).]]

	~~[[File:Tear system.png\|thumb\|Right eye lacrimal system consisting of: of lacrimal gland (a), punctums (b,e), canalicules (c,f), lacrimal sac (g,d).]]~~
	~~[[File:eyelid glands.png\|thumb]]~~

	==Clinical Features==		==Clinical Features==

← Revisión anterior		Revisión del 22:14 23 oct 2024
Línea 24:		Línea 24:
	==See Also==		==See Also==
	*[[Periorbital vs Orbital Cellulitis]]		*[[Periorbital vs Orbital Cellulitis]]
			*[[Ocular and periocular diagnoses]]

	{{Eye algorithms}}		{{Eye algorithms}}

← Revisión anterior		Revisión del 21:52 23 oct 2024
Línea 1:		Línea 1:
	==Background==		==Background==
			[[File:Gray896.png\|thumb\|Anterior view of the right eye, with lacramal duct shown medial.]]
			[[File:Gray894.png\|thumb\|The tarsi and their ligaments. Right eye; anterior view.]]
			[[File:eyelid glands.png\|thumb]]

	[[File:Tear system.png\|thumb\|Right eye lacrimal system consisting of: of lacrimal gland (a), punctums (b,e), canalicules (c,f), lacrimal sac (g,d).]]		[[File:Tear system.png\|thumb\|Right eye lacrimal system consisting of: of lacrimal gland (a), punctums (b,e), canalicules (c,f), lacrimal sac (g,d).]]
	[[File:eyelid glands.png\|thumb]]		[[File:eyelid glands.png\|thumb]]

← Revisión anterior		Revisión del 09:35 22 mar 2026
Línea 3:		Línea 3:
	[[File:Gray896.png\|thumb\|Anterior view of the right eye, with lacrimal duct shown medial.]]		[[File:Gray896.png\|thumb\|Anterior view of the right eye, with lacrimal duct shown medial.]]
	*This page describes a general approach to the complaint of periorbital swelling		*This page describes a general approach to the complaint of periorbital swelling
	*The critical EM distinction is ~~'''~~preseptal (periorbital) cellulitis vs. orbital cellulitis~~'''~~		*The critical EM distinction is preseptal (periorbital) cellulitis vs. orbital cellulitis
	**The orbital septum is the key anatomic landmark separating the two		**The orbital septum is the key anatomic landmark separating the two
	**~~'''~~[[Preseptal cellulitis]]~~'''~~: infection anterior to the orbital septum — common, usually manageable outpatient		**[[Preseptal cellulitis]]: infection anterior to the orbital septum — common, usually manageable outpatient
	**'''[[Orbital cellulitis]]''': infection posterior to the orbital septum — emergency with vision-threatening and life-threatening complications		**'''[[Orbital cellulitis]]''': infection posterior to the orbital septum — emergency with vision-threatening and life-threatening complications
	*Other important causes include allergic reactions, insect stings, [[angioedema]], and [[nephrotic syndrome]]		*Other important causes include allergic reactions, insect stings, [[angioedema]], and [[nephrotic syndrome]]
Línea 26:		Línea 26:
	*Extent and distribution of swelling (unilateral vs. bilateral, periorbital vs. diffuse face)		*Extent and distribution of swelling (unilateral vs. bilateral, periorbital vs. diffuse face)
	*Erythema, warmth, tenderness		*Erythema, warmth, tenderness
	*~~'''~~Key findings distinguishing orbital from preseptal cellulitis:~~'''~~		*Key findings distinguishing orbital from preseptal cellulitis:
	**Pain with extraocular movements (orbital)		**Pain with extraocular movements (orbital)
	**Proptosis (orbital)		**Proptosis (orbital)
Línea 50:		Línea 50:

	===Infectious===		===Infectious===
	*~~'''~~[[Preseptal cellulitis]]~~'''~~ (most common infectious cause)		*[[Preseptal cellulitis]] (most common infectious cause)
	*'''[[Orbital cellulitis]]''' (emergency — often from adjacent sinusitis)		*'''[[Orbital cellulitis]]''' (emergency — often from adjacent sinusitis)
	*Dacryocystitis (medial canthal swelling)		*Dacryocystitis (medial canthal swelling)
Línea 87:		Línea 87:

	===Imaging===		===Imaging===
	*~~'''~~CT orbits with contrast (with thin cuts through sinuses)~~'''~~: gold standard for distinguishing orbital from preseptal cellulitis		*CT orbits with contrast (with thin cuts through sinuses): gold standard for distinguishing orbital from preseptal cellulitis
	**Evaluates for orbital abscess, subperiosteal abscess, sinusitis, and cavernous sinus		**Evaluates for orbital abscess, subperiosteal abscess, sinusitis, and cavernous sinus
	*CT should be obtained whenever orbital cellulitis is suspected		*CT should be obtained whenever orbital cellulitis is suspected
Línea 100:		Línea 100:

	===Orbital Cellulitis===		===Orbital Cellulitis===
	*~~'''~~Admit~~'''~~ for IV antibiotics: [[vancomycin]] + [[ceftriaxone]] (or [[ampicillin-sulbactam]] + vancomycin)		*Admit for IV antibiotics: [[vancomycin]] + [[ceftriaxone]] (or [[ampicillin-sulbactam]] + vancomycin)
	*ENT and ophthalmology consultation		*ENT and ophthalmology consultation
	*Surgical drainage for subperiosteal or orbital abscess if meeting criteria (large abscess, no improvement with IV antibiotics, vision compromise)		*Surgical drainage for subperiosteal or orbital abscess if meeting criteria (large abscess, no improvement with IV antibiotics, vision compromise)