Pediatric periorbital cellulitis: what parents should know

Periorbital cellulitis affects the skin and tissues around the eye, often causing one-sided [Skin Swelling](/symptoms/skin-swelling/), warmth, tenderness, and [Skin Redness](/symptoms/skin-redness/). A child may have a fever or [Painful Skin](/symptoms/skin-pain/), sometimes after a scratch, insect bite, sinus problem, or another nearby infection. It is different from deeper infection behind the eye, which can threaten vision and movement. A clinician needs to examine the eye and the child’s general condition to distinguish them. Read the broader [Cellulitis](/conditions/cellulitis/) overview for context.

Contact a healthcare professional promptly when swelling and redness develop around a child’s eye. Treatment may involve prescribed antibiotics, with the route and setting chosen according to age, severity, eye findings, and response. Give medicine exactly as directed and do not use leftover antibiotics or squeeze the swollen area. Keep the child hydrated and note changes in temperature, pain, swelling, eye movement, and vision. Tell the clinician about recent injuries, insect bites, sinus symptoms, skin infections, or conditions that affect immunity. A child with a significant medical condition may need a lower threshold for assessment.

Go to emergency care immediately for pain when moving the eye, reduced or double vision, an eye that appears pushed forward, inability to open the eye, severe headache, vomiting, confusion, or marked sleepiness. Seek urgent help as well when swelling is rapidly worsening, fever is persistent, the child is not drinking, or the child looks seriously unwell. These signs can indicate deeper spread or a severe infection such as [Sepsis](/conditions/sepsis/), not a minor surface irritation.

Ask whether the infection is limited to tissues in front of the eye, which treatment is needed, and when improvement should begin. Ask which eye changes require immediate return, how to give each dose, and whether an underlying sinus, dental, or skin source needs attention.