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Preseptal/orbital cellulitis

The following information provides a guide for GPs on how to manage or make a referral for presentation of Preseptal/orbital cellulitis in children.

  • Early, Mild, Moderate

    • Mild lid swelling/redness and/or obvious chalazion, insect bite or scratch
    • No raised temperature
    • Normal vision

     

    Do not refer (GP management)

  • Severe

    • If no improvement or worsening after 48 hours of oral antibiotics

     

    Urgent referral to acute eye clinic

  • Potential serious pathology

    Suspected orbital cellulitis:

    • Raised temperature
    • Unwell child
    • Eye (conjunctiva) red
    • Pupil dilated
    • Limited eye
    • movements
    • Blurred vision

     

    Urgent-referral to local paediatric service for intravenous antibiotics

Referral information

Always include:

  • Child’s date of birth
  • Address
  • Child’s social worker details (including Borough), if any
  • Parent/carer contact phone number and e-mail

 

GP management

Oral antibiotic e.g. oral co-amoxiclav if there are no penicillin allergies

 

Further assistance

This pathway has been produced by Moorfields Eye Hospital NHS Foundation Trust to help clinicians manage the healthcare of children and young people. However, if you need to contact a paediatric clinician, please see below for contact details:

Moorfields Eye Hospital:

Paediatric helpline: 0207 2533411 extn 4569, Mon- Fri 10:00am-13:00pm then 14:00pm-16:00pm

 

Last updated: April 2021