Orbital Cellulitis and Retrobulbar Abscesses - Cat and Dog

Introduction

Orbital Cellulitis is an infection of the tissue surrounding the eye. If frequently localises and progresses to form Retrobulbar Abscesses.

The aetiology is uncertain but assumed to be secondary to haematogenous spread or penetrating foreign bodies. Anaerobic culture is frequently required to produce any growth from samples. Pasteurella has been grown from dogs with orbital cellulitis, whilst Aspergillus and Penicillium has been grown from cats.

Clinical Signs

Exopthalmos

Periorbital swelling

Pain on opening of mouth

Hyperemia and swelling of oral mucosa caudal to rear upper molar tooth

Protrusion of third eyelid

Pyrexia

Chemosis, usually unilateral

Anorexia

Clinical signs are usually rapid in onset.

Diagnosis

Clinical signs are often pathognomic.

A complete blood count may show signs of infection.

Ultrasound may confirm the presence of an abscess. Radiography should be consider if a foreign body is suspected.

Treatment

Drainage should be attempted by making a stab incision through the oral mucosa caudal to the rear upper molar tooth, followed by careful blunt dissection to the orbit. It is advisable to submit any exudate drained for culture. The orbit should be gently flushed with sterile saline and broad spectrum antibiotics administered until culture results are received. Antibiotics should be administered for at least 7 days.

Control

If clinical signs do not resolve or recur, further investigation or surgery should be undertaken to rule out foreign bodies. Persistent infection from the roots of upper molar teeth is another possibility to be ruled out.

References

Maggs, D et al (2007) Slatter's Fundamentals Of Veterinary Ophthalmology (Fourth Edition) Saunders

Peiffer, Robert J, and Petersen-Jones, Simon M (2008) Small Animal Ophthalmology (Fourth Edition) Saunders