when there is concern for sinusitis, an odontogenic source, or proven or suspected intracranial extension Goals of Treatment Accurate identification of periorbital versus orbital cellulitis is essential to proper treatment and a favorable clinical outcome Timely administration of appropriate antibiotics is critical in all cases Prompt recognition of symptoms and appropriate use of imaging allows for early diagnosis of orbital cellulitis, a potentially vision- and life-threatening condition Ophthalmology consultation is indicated in all cases of suspected or proven orbital cellulitis Surgical intervention may be required Otolaryngology consultation should be sought when there is concurrent sinonasal pathology FIGURE 123.4 Periorbital cellulitis in a child with eyelid swelling, erythema, and tenderness Clinical Considerations Clinical Recognition Both periorbital and orbital cellulitis are more often seen in children than adults Both conditions commonly present with fever, and periorbital erythema, pain, and swelling ( Fig 123.4 ) Any pediatric patient who presents with these findings requires careful examination to rule out orbital cellulitis The clinician should also recognize the signs of local and systemic