Orbital cellulitis: what to know

Orbital cellulitis affects the tissues behind the eye's protective membrane, rather than only the eyelid surface. Infection can spread from the sinuses, nearby skin, a wound, or another focus. Typical findings include a painful swollen eyelid, redness, fever, pain when the eye moves, reduced eye movement, double vision, or a bulging eye. Vision changes are especially concerning.

The condition is not the same as a small stye or simple irritation. It can progress into nearby spaces or the bloodstream, which is why assessment should happen urgently even if the skin opening seems minor. Read about related [Skin Swelling](/symptoms/skin-swelling/) and [Skin Redness](/symptoms/skin-redness/).

Go to an emergency department rather than treating suspected orbital cellulitis at home. The medical team will assess vision, pupils, eye movement, temperature, and general health. They may arrange imaging and blood tests, then start prescription antibiotics, often through a vein, with review by eye or other specialists. An abscess, sinus source, or poor response may require a procedure or a change in treatment. Take only medicines recommended for this episode and do not use leftover antibiotics.

Seek emergency help immediately for blurred or reduced vision, double vision, pain with eye movement, a bulging eye, severe headache, vomiting, confusion, unusual sleepiness, or quickly worsening swelling. Fever and spreading redness also need prompt assessment. Collapse, breathing difficulty, or rapidly worsening illness may indicate sepsis and requires emergency services.

Ask whether the orbit or sinuses are involved, how vision will be monitored, whether imaging is needed, how long treatment is expected to continue, and which symptoms mean you should return immediately.