CLINICAL PRACTICE GUIDELINES (FULL LIST)

Periorbital - Orbital Cellulitis (CPG)

Periorbital (preseptal) and orbital cellulitis represent a spectrum of pediatric infections involving the tissues surrounding the eye, ranging from superficial infection to potentially vision- and life‑threatening disease. While periorbital cellulitis is typically localized anterior to the orbital septum, orbital cellulitis involves deeper orbital structures and may be associated with serious complications including abscess formation, vision loss, intracranial extension, and cavernous sinus thrombosis. Timely recognition and appropriate management are therefore critical.

This clinical pathway provides evidence‑based guidance for the evaluation and management of children with suspected periorbital or orbital cellulitis. The pathway outlines key clinical features that help distinguish periorbital from orbital disease, recommendations for diagnostic imaging and laboratory evaluation, criteria for hospital admission and subspecialty consultation, and guideline‑concordant antimicrobial therapy.

The goals of this pathway are to standardize care, promote optimal antimicrobial stewardship, and improve patient outcomes by supporting clinicians in delivering safe, efficient, and high‑quality care for children with periorbital and orbital cellulitis.

Authors:

• ID: Sophie, Ritu
• PHM: Me and Jim Antoon (Ellen Minaldi was a resident at that time that helped!)
• Ophtho: Louise Mawn
• ENT: Jim Phillips
• ER: Barron Frazier (helped us build orderset)