Why does orbital cellulitis occur, and why is it an emergency?
The bony entrance to the orbit is curtained by the orbital septum. This structure separates the eyelids andexternal structures from the orbit itself. Infection of the lid structures is therefore called preseptal cellulitis. It requires systemic antibiotics to resolve – oral in healthy adults but children may need IV – and does so without sequelae. But if the infection either begins in the orbit itself, usually from a nearby sinus, or a preseptal cellulitis breaks through the septum into the orbit, it is potentially much more serious. The reason for this is that the infection can then gain access to the brain. Orbital cellulitis is characterised by an acutely unwell patient with swollen, red lids, double vision (if the lids are opened) and signs of optic nerve dysfunction. It is a sight- and life-threatening emergency and the patient should be transferred to specialist care immediately. 9 Does dacryocystitis in the adult need operative intervention? Dacryocystitis is an inflammation of
