Meet Arjun, my older son! A swollen lid like this one can be alarming to see on your child, and in many cases can be serious and need antibiotic treatment. Thankfully, his was a mild case of preseptal cellulitis due to a mosquito bite and resolved on its own within two days. Preseptal cellulitis is an infection of the soft tissue around the eyelid. It is mostly common in children and can be caused by insect bites, trauma to the eye, or bacterial infection spread from a sinusitis. Usually this type of infection involves one eye and causes redness and swelling as well as eyelid drooping if the upper lid is affected. There is usually very little pain or impact on vision.
Orbital cellulitis is a similarly presenting condition that is much more serious and can be life threatening in some cases depending upon the spread of the infection. This condition is caused as a result of the infection spreading to the back of the eye past a structure called the orbital septum. The orbital septum is a thin membrane that separates the anterior part of the eyelid muscle called orbicularis oculi from the intraorbital fat in the posterior part. Orbital cellulitis can occur due to the progression of preseptal cellulitis if not treated appropriately or can develop on its own due to bacterial or rarely fungal infections in or around the eyes (for example, dental infections), trauma, or orbital surgery. Orbital cellulitis can cause pain, decreased vision, difficulty with eye movement, and fever in addition to the swelling and redness.
Depending on the severity of the infections, antibiotic therapy may be necessary in most cases to treat preseptal or orbital cellulitis. If these types of infections are not diagnosed and treated quickly and appropriately, they can cause blindness or spread to the brain and lead to permanent neurologic damage, meningitis, or other life threatening conditions. Remember, if you or your loved ones are experiencing any eye-related conditions like redness, pain, swelling, and/or tearing, we are always available to evaluate and rule out any potential infections such as these ones.