症例 challenge · Ophthalmology / ENT / Pediatrics · teaching

Orbital Cellulitis (Postseptal) — Pathway · case challenge

Given a case, work through the care pathway step by step; the tool checks each choice and scores you. Decisions and basis are taken from this site's reviewed care pathways.

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Case #1Ophthalmology / ENT / Pediatrics

📋 Case data

Preseptal vs postseptalPreseptal (eyelid swelling only, none of the above)

Data is taken from this pathway's reviewed node text. Work through the pathway step by step.

Step 1 / 1 · Preseptal vs postseptal

Preseptal vs postseptal? (pain on eye movement/proptosis/ophthalmoplegia)

💡 Infection of postseptal soft tissue (muscle/fat) (vs preseptal = eyelid only); more common in children, 86–98% from sinusitis (ethmoid), also odontogenic/traumatic. Key distinguishing features: pain on eye movement + proptosis + ophthalmoplegia + chemosis ± reduced vision/RAPD + fever and raised WBC (eyelid swelling occurs in both and does not differentiate); bilateral → suspect cavernous sinus thrombosis. Complications: vision loss (~11%)/subperiosteal or orbital abscess/cavernous sinus thrombosis/meningitis/brain abscess.

For teaching. Decisions and their basis are taken from this site's reviewed care pathways; for licensed clinicians/trainees, this does not replace clinical judgment or local protocols.