Question

Which of the following is true about orbital cellulitis?

• A. The inflammation is confined anterior to the orbital septum
• B. Ethmoidal sinusitis is the most common cause in all age groups
• C. It presents with proptosis, but pupillary reflexes and extraocular movements remain normal
• D. Broad-spectrum topical antibiotics are the treatment of choice

Hint:

Orbital cellulitis commonly follows ethmoid sinusitis and presents with proptosis and restricted eye movements.

Answer 1

The Correct Option is B

Concept: Orbital cellulitis is an infection involving tissues posterior to the orbital septum. It commonly occurs due to spread of infection from the paranasal sinuses, especially the ethmoid sinus.

Step 1: Differentiate orbital from preseptal cellulitis.
Preseptal cellulitis is anterior to the orbital septum, while orbital cellulitis is posterior to the septum.

Step 2: Identify the common source.
The ethmoid sinus is very close to the orbit, separated by the thin lamina papyracea. Hence, ethmoidal sinusitis can easily spread to the orbit.

Step 3: Check clinical findings.
Orbital cellulitis can cause: \[ \text{Proptosis + painful eye movement + restricted extraocular movements + visual risk} \] It requires systemic antibiotics, not only topical antibiotics. Therefore, the correct answer is Ethmoidal sinusitis is the most common cause in all age groups.