This guideline last updated 09/05/2022 9:55:24

Differential diagnosis

• Facial cellulitis
• Preseptal cellulitis
• Orbital cellulitis
• Acute frontal sinusitis
• Infection following superficial trauma/abrasion of skin

Possible management by Optometrist

Treatment

• Do not syringe or probe
• Co-manage with GP patients with associated pre-septal cellulitis but 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

• Hospital admission is required if patient is febrile and/or systemically unwell or if an abscess has developed (i.e. pointing on surface)

Management Category

• Urgently refer (same day)
• All children
• Severe cases in adults
• Refer within one week, milder cases not responsive to systemic antibiotic within 7 days
• Chronic cases without inflammation
• May respond to hot compresses/massage
• Only require referral if recurrent episodes

Possible management by Ophthalmologist

• Incision and drainage where appropriate
• Systemic (including parenteral) antibiotics
• Follow-up may include investigation and surgical intervention for nasolacrimal duct obstruction