Abstract
Purpose::
Infection of the eyelids confined to the preseptal space is relatively common and most patients are treated on outpatient basis and seldom admitted to a tertiary eye care center unless there is a suspicion for orbital cellulitis. At times, distinguishing between preseptal and orbital cellulitis can be difficult based on clinical observations alone. The aim of this study was to investigate the causes and outcome of treated preseptal cellulitis in patients admitted to a tertiary eye care center.
Methods::
Retrospective, non-comparative, interventional case series of patients admitted to a tertiary eye care center with the diagnosis of preseptal cellulitis were reviewed for outcome of their treatment over a 10-year period. Parameters studied included causes of preseptal cellulitis, presenting signs and symptoms and the outcome of treatment.
Results::
Of the 85 patients (49 male, 36 female; average age 19.4 years), 30 (35%) had evidence of acute dacryocystitis, 22 (26%) had existing upper respiratory tract infection/sinusitis and 15 (18%) had recent history of trauma. Less common causes included, a history of recent ocular or periocular surgery in 9 (11%) patients, blepharitis/chalazion in 4 (5%) and conjunctivitis in 4 (5%) patients. Computerized tomography was performed in 38 (45%) patients to exclude any orbital process. All patients were treated with intravenous antibiotics ranging from 1 to 11 days (average 3.5 days) and all responded with resolution of their acute symptoms. All patients required oral antibiotics on discharge ranging from 2 to 7 days. Among the 30 patients with preseptal cellulitis due to acute dacryocystitis, 18 (60%) patients required dacryocystorhinostomies (DCR) to prevent recurrence of acute infection. Adult patients were more likely to require DCR than children to prevent recurrence of acute dacryocystitis and preseptal cellulitis.
Conclusions::
Most common causes of preseptal cellulitis among patients admitted to a tertiary eye care center include acute dacryocystitis, upper respiratory tract infection/sinusitis and trauma. Preseptal cellulitis has a typically benign course when treated early, the clinical course depending on age of the patient and etiology.
Keywords: clinical (human) or epidemiologic studies: prevalence/incidence • bacterial disease • trauma