Question 1

A child's optic assessment data include unilateral eyelid edema, warmth, and erythema but no pain with ocular movement is reported. Which characteristic is most likely true about this child's infection?

A) Decreased visual acuity may occur.
B) Increased intraocular pressure will be present.
C) Optic nerve compromise is a complication.
D) The eye is typically spared without conjunctivitis.

D

Accepted Answer

The presence of eyelid edema, warmth, and erythema without pain with ocular movement suggests a bacterial infection of the eyelid (i.e., preseptal cellulitis). This type of infection typically does not involve the eye itself and is not associated with conjunctivitis or other ocular symptoms. However, if the infection spreads to involve the orbit (i.e., postseptal cellulitis), then it may cause visual changes, increased intraocular pressure, and optic nerve compromise.

Question 2

A patient is experiencing eyelid swelling with erythema and warmth and reports pain with eye movement. Which diagnostic tests will be performed to confirm a diagnosis of orbital cellulitis? (Select all that apply.)

A) Blood cultures
B) Complete blood count
C) CT scan of orbits
D) Lumbar puncture
E) Visual acuity testing

B, C

Accepted Answer

B, C

Question 3

Which is the most common cause of orbital cellulitis in all age groups?&#10;A) Bacteremic spread from remote infections&#10;B) Inoculation from local trauma or bug bites&#10;C) Local spread from the ethmoid sinus&#10;D) Paranasal sinus inoculation

Accepted Answer

Local spread from the ethmoid sinus is the most common cause of orbital cellulitis in all age groups. The ethmoid sinus is located near the orbit and infection can spread easily from the sinus to the orbit. Bacteremic spread from remote infections, inoculation from local trauma or bug bites, and paranasal sinus inoculation are all possible causes of orbital cellulitis, but they are not as common as local spread from the ethmoid sinus.

Deck 59: Preseptal and Orbital Cellulitis