A retrospective observational study of orbital cellulitis in children - Recent trends

Orbital cellulitis is an acute post-septal orbital infection caused mostly by bacteria. This may result in serious complications including blindness, meningitis, cavernous sinus thrombosis, brain abscess, and even death. The delay in treatment increases morbidity and mortality. The purpose of present study was to review cases of orbital cellulitis in recent years regarding its clinical presentation, diagnostic evaluation, treatment policy, complications, and disabilities. The outcome of study will help in early diagnosis and better management of orbital cellulitis cases.

Total 20 cases of orbital cellulitis in children from March 2021 to February 2024 were evaluated and analyzed in department of ophthalmology, Patna Medical College and Hospital, Patna.

Total 20 children with ages <18 years were evaluated. The average age of presentation was 7 years (range between 1 year and 17 years). 70% of cases were seen in male children. All patients presented with chemosis, congestion, eyelid swelling, proptosis, and restriction of eye movement. Orbital CT scan diagnosed 100% cases of orbital cellulitis (P < 0.01). In 45% of children, sinusitis was initial site of infection (P < 0.01). Swab culture was positive in 40% of the cases, organism being gram-positive cocci. Complete recovery was seen in 75% with 25% having some deficit in visual acuity or eye movement.

Clinical symptoms and signs aided with orbital CT scan help in early diagnosis early detection and aggressive treatment with multidisciplinary approach may limit the complications of orbital cellulitis and also aid in complete recovery without any visual deficit.