A 5-year-old boy has 3 days of right eyelid swelling and fever. He has marked tenderness of the upper lid, but the key finding on examination is forward displacement of the globe with restriction of abduction and pain on attempted eye movement. This finding establishes the diagnosis as:

• A Orbital cellulitis ✓
• B Preseptal cellulitis
• C Dacryoadenitis
• D Idiopathic orbital inflammatory disease

Explanation

Preseptal cellulitis involves tissues anterior to the orbital septum and spares the orbit itself, so vision, pupillary reactions, ocular motility and globe position remain normal. Proptosis, restricted and painful extraocular movements, chemosis, or visual loss indicate posterior extension across the septum, defining orbital cellulitis, usually from ethmoid sinusitis in children. It demands imaging for subperiosteal or orbital abscess and admission for intravenous antibiotics. Dacryoadenitis localizes to the superotemporal lacrimal gland.

Reference: Parsons' Diseases of the Eye, 23rd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.