Orbital Cellulitis and Orbital Abscess
 
Description of the Disease and Clinical Picture
Orbital cellulitis represents inflammation of the soft tissues of the orbital space. The cause is often a sharp foreign body that penetrates through the oral cavity behind the last molar, through the conjunctiva or eyelids, reaching the orbit. Cellulitis can be a consequence of systemic infections or occur due to the transmission of infection from other surrounding structures: salivary glands, nasal or sinus cavity, and oral cavity (especially teeth). Endophthalmitis and panophthalmitis can lead to orbital cellulitis. An abscess often forms, and the most commonly isolated bacteria from the abscess are Pasteurella spp, E. coli, Staphylococcus spp, and Bacteroides. Orbital abscess is often the result of vasculitis (inflammation of the blood vessel wall). As a consequence of vasculitis and increased permeability of blood vessels, bacteria can migrate from any part of the body (most commonly from inflamed skin) into the orbital space and cause the formation of an orbital abscess. Vasculitis can be confirmed by histopathological analysis of a soft tissue sample from the orbit. Persistent drug control of vasculitis is a very significant step in abscess therapy, as recurrence of the abscess has been observed in patients if vasculitis control is not established. Sometimes, the cause of cellulitis can be fungal or parasitic infections. The clinical picture most commonly shows acute, unilateral exophthalmos with protrusion of the third eyelid, conjunctival hyperemia and chemosis, episcleral congestion, and mucopurulent discharge from the eye. Periocular swelling is more or less pronounced and there is severe pain upon opening the jaw.
 
Therapy
The diagnosis is made through a detailed clinical examination with the help of radiography (when a metallic foreign body or bone fracture can be observed), ultrasound, and computerized tomography (CT). The foreign body must be removed, and the abscess drained (access through the oral cavity or retrobulbar). Local irrigation with antibiotics is used, as well as systemic antibiotics and nonsteroidal anti-inflammatory drugs.
 
Please contact our specialty veterinary ophthalmology hospital Animal Eye Consultants
of Iowa (animaleyeiowa@gmail.com) in USA or Oculus Veterinary Specialty Hospital
(oculusklinika@gmail.com) in Serbia, Europe to schedule an appointment so your pet
can be seen.