Advice intended for parents/carers taking their child home after seeing a hospital based healthcare professional

Periorbital cellulitis is an infection of the eyelid or skin around the eye. It is almost always one sided and sometimes follows a cut or graze to the skin.


  • Swollen eyelid
  • Eye area can be red, tender and warm to touch
  • Fever may be present
  • Your child may be unable to open the eye fully


  • Periorbital cellulitis can follow a minor injury to the eye
  • It can also occur following another infection, such as a cough or cold, where the infection spreads to the eye or following sinusitis.

When to seek further help:

If your child has any of the following:

  • Becomes pale, mottled and feels abnormally cold to touch
  • Has blue lips
  • Severe breathing difficulty - too breathless to talk / eat or drink
  • Has a fit / seizure
  • Becomes extremely agitated, confused or very lethargic (difficult to wake)

You need urgent help

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following:

  • Develops a continous headache despite regular painkillers (paracetamol and ibuprofen)
  • Continues to vomit repeatedly
  • Develops a severe pain behind their eye
  • Develops a squint (eyes pointing in different directions) or starts complaining about double vision or needs to cover up one eye to see or complaining of blurred vision
  • Coordination issues or finding it hard to balance
  • Develops weakness in an arm or leg
  • They can no longer open their eye
  • Is finding it hard to breathe
  • Seems dehydrated (sunken eyes, drowsy or no urine passed for 12 hours)
  • Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) – especially if they remain drowsy or irritable despite their fever coming down
  • Has extreme shivering or complains of muscle pain
  • Continues to have a fever of 38.0°C or above for more than 5 days
  • Is getting worse or if you are worried

You need to contact the discharging ward urgently

  • If none of the above features are present

Self Care

Continue providing your child’s care at home using the advice below. If you are still concerned about your child, speak to your health visitorlocal pharmacist or call NHS 111– dial 111. Keep monitoring your child for red and amber features and seek help if they develop


Periorbital cellulitis usually responds well to antibiotics. Treatment with intravenous antibiotics (given into a vein) is usually only needed for more severe cases or those that have not responded to antibiotics given by mouth.

Some children who need intravenous antibiotics are admitted to hospital initially whilst others can be looked after at home. These children would come into hospital once a day for someone to look at them and for their antibiotics to be given.

The decision on when to change from intravenous to oral antibiotics (tablets or liquid) will be made by the medical team caring for your child. This will depend on how quickly your child responds to treatment (improvement in fever, pain and sometimes their blood tests) and whether your child has other health conditions. Antibiotics are usually given for a total of 10 days. You can give regular pain relief (Paracetamol or Ibuprofen) until any discomfort has improved.


Most children recover without any complications. However, periorbital cellulitis can occasionally progress to orbital cellulitis. This is where the infection involves the deeper tissues around the eye and the eyeball itself.

This is a serious infection, which can cause lasting problems and needs immediate care.

If you are concerned that your child's condition is getting worse, (see table above) you should contact your discharging ward.

Call 999 for an ambulance if you have serious concerns for your child.


It is not always possible to prevent this infection. However, it is important to have your child fully vaccinated, as two of the bacteria known to cause this infection are covered within your child's current vaccination schedule.

Keep any minor injuries surrounding the eye clean and dry. Remember good hand hygiene before and after cleaning around the eye.

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