Clinical Presentation and Risk Factors for Orbital Infections in a Tertiary Hospital

Background: Orbital infections are common ophthalmic emergencies with sight and life threatening if not promptly and adequately managed. Purpose: To determine the incidence of orbital infections and the risk factors that predispose these patients to orbital infections in our tertiary health institution. Methods: Records of all patients with orbital infections who presented at the ophthalmic plastic clinic between January 2010 and December 2019 were retrieved. Demographic characteristics, duration of symptoms, presenting visual acuity, and oculoplastic procedures were obtained. Results: Sixty six patients presented with orbital infections which constituted (4.5%) of all ocular emergencies seen in this centre. There were 44 (66.7%) males and 22 (33.3%) females. Preseptal cellulitis was 49 (74.2%) while orbital cellulitis was 17 (25.8%). More than 9/10th of preseptal cellulitis were found in children of 5 years and below. The proportion of visual impairment and blindness was higher in orbital cellulitis than preseptal cellulitis. The most common risk factors for preseptal cellulitis was ocular allergy while sinus infection was commonest in orbital cellulitis. All patients with orbital cellulitis were admitted into the eye wards out of which 2 (11.8%) of these patients died of septiceamia. Conclusion: Orbital infection is a relatively common ophthalmic emergency which is a cause of visual impairment and blindness. The most common risk factor for preseptal cellulitis was ocular allergy while sinus infection was commonest in orbital cellulitis. Aggressive and goal oriented awareness campaign for early presentation of patients with these infections at eye care facility is advocated to prevent unnecessary death from this ophthalmic emergency.