A 6-year-old boy has 2 days of eyelid swelling and redness. Which single examination finding best distinguishes orbital cellulitis from preseptal cellulitis?

• A Fever above 38 degrees Celsius
• B Recent history of upper respiratory tract infection
• C Tender erythematous eyelid swelling
• D Painful restriction of ocular movements with proptosis ✓

Explanation

Orbital cellulitis involves the tissues posterior to the orbital septum, so it produces proptosis, painful ophthalmoplegia, chemosis, and often visual loss or an afferent pupillary defect. Preseptal infection is confined anterior to the septum and the globe remains normal. Fever, tender lid swelling, and a preceding cold occur in both conditions and do not localise the infection behind the septum.

Reference: Kanski's Clinical Ophthalmology, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.