Orbital Cellulitis: Pathogenesis and Clinical Findings
Definitions:
a. Chemosis: Edema of the bulbar conjunctiva
b. Panopthalmitis: inflammation of all coats of the eye including intraocular structures.
c. Endopthalmitis: inflammation of the interior of the eye.
• Spreads to periorbital tissue (anterior to the orbital septum) -> Localized inflammation -> Conjunctival chemosis -> Eyelid and periorbital edema -> Pain on palpation -> Induration, Warmth
• Inflammation of orbital tissue
- Impinges on ocular muscles -> Impaired extra-ocular movements -> Pain with eye movement or opthalmoplegia
- Impinges on nerves -> Afferent pupillary defect -> Decreased visual acuity
- Proptosis -> Exposes cornea -> Corneal drying and scarring
• Spreads to surrounding structures -> Subperiosteal abscess -> Brain abscess -> Cavernous sinus thrombosis -> Meningitis -> Subdural empyema -> Orbital abscess
• Involves the orbit -> Panopthalmitis -> Endopthalmitis -> Blindness
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