VERIFIED CONTENTAuthor: Klaudia Kierzkowska, graduate of chemistry at the University of Warsaw

Inflammation of the tissues of the orbit, which is manifested by exophthalmos, pain and redness, is a dangerous inflammatory process. The condition is usually chronic and requires immediate treatment.

Orbital inflammationis an inflammation of the cavity in the skull that is below the frontal portion where the eyeball fits. The orbital, by the orbital septum, is divided into two parts - the superficial tissues of the orbital and the elements located deep inside the orbit.

Orbital soft tissue inflammationis an inflammation which, due to its structure, is divided into:

  • pre-septal inflammation ( preseptal cellulitis ),
  • inflammation of the orbital cellulitis ( orbital cellulitis ).

What are the causes of orbital tissue inflammation?

Tissue inflammation is largely associated with the increased incidence of upper respiratory tract infections. In children under 9 years of age, a single pathogen is most often responsible for infection, while over 15 years of age, mixed flora is usually isolated. The cause oforbital tissue inflammationis chronic inflammation of the paranasal sinuses, which results from both valvular and valvular connections between the facial and orbital venous systems, as well as the proximity of structures.

One of the most common causes is the transmission of the infection from the paranasal sinuses or the generalization of local inflammatory processes within the orbit. Sometimes inflammation occurs after orbital fractures or following surgery. Inorbital inflammationscomplicating sinusitis, the most common pathogen isStreptococcus pneumoniae , however other cocci are also indicated.

In turn, in cases of accompanying dermatitis or in the course of trauma, the etiological factors areStaphylococcus aureusandStreptococcus pyogenes- less often anaerobic bacteria.

Symptoms of orbital inflammation

Symptoms of orbital tissue inflammation are easily noticeable.Exophthalmos appears, often masked by eyelid edema. Inflammationis characterized by a one-sided, red, painful and excessively warm periorbital swelling.

Usually there is a restriction in the mobility of the eyeball and a progressive weakening of visual acuity. Swelling of the eyelid and inflammatory infiltrate often lead to the closure of the eyelid fissure. There may be symptoms of conjunctivitis, lacrimation, and in the case of infection with viruses from the groupHerpesskin vesicles.

Sometimesinflammation of the orbital tissuesaccompanies:

  • fever,
  • color vision disorders,
  • spots in the field of view,
  • increased intraocular pressure.

Diagnosis of orbital tissue inflammation

The symptoms of orbital inflammationare so characteristic that it is relatively easy to make a correct diagnosis. Diagnostics includes an ophthalmological examination, during which a specialist will check: color vision, visual acuity, pupil reflexes, visual field, intraocular pressure.

The doctor will also examine the bottom of the eye and perform a slit lamp examination. To distinguishorbital tissue inflammationfrom pre-septal inflammation, a CT scan should be performed. In the case ofinflammation of the orbital tissuesincreased tissue saturation concerns the tissues in front of the septum and in the eye socket itself.

Treatment of orbital inflammation

Orbital inflammation can lead to serious complications , therefore hospitalization and ophthalmological monitoring is necessary on average every 4 hours. Treatment includes intensive antibiotic therapy - intravenously or intramuscularly. Many bacteria contribute to the development of infection, so the use of broad-spectrum antibiotics is recommended.

In some cases, steroid therapy is recommended, but it can be implemented only after min. 2 days from the start of antibiotic therapy. Failure to respond to antibiotic therapy, the presence of an abscess (over 10 mm in diameter) or deterioration of visual acuity are indications for surgery. In some cases, drainage of the infected sinus is essential.

Complications after orbital inflammation

Orbital tissue inflammation , in extreme cases, may lead to blindness and, very rarely, even death of the patient (1-2%). Serious complications may arise, including:

  • corneal damage,
  • increased intraocular pressure,
  • endophthalmitis,
  • closure of the central retinal artery and vein.

A harbinger of intracranial complications (meningitis, cavernous sinus thrombosis) that occurrelatively rarely, there are vomiting, headache and symptoms of palsy of the cranial nerves.