Angioneurotic oedema (if bilateral- could indicate severe systemic allergic reaction)
Orbital cellulitis
Cavernous sinus thrombosis
Mucormycosis (fungal infection)
Sarcoidosis
Dysthyroid exophthalmos
Neoplasia with inflammation
Acute allergic conjunctivitis
Possible management by Optometrist
Treatment
Orbital cellulitis-none
Pre-septal cellulitis- co manage with GP adult patients who are systemically well
POM Co-amoxiclav 500/125 mg every 8 hours for 7 days then review
If allergic to penicillin, then POM Erythromycin 500 mg 4 times a day for 5–7 days then review
Advice
Orbital cellulitis and paediatric pre-septal cellulitis- Emergency (same day) referral
Pre-septal cellulitis in adults
Management Category
Emergency (same day) referral to ophthalmologist or A&E Department
Possible management by Ophthalmologist
Systemic antibiotics (parenteral and/or oral)
Drainage of orbital abscess
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