Which of the following best describes the symptoms of orbital cellulitis?

• A. Unilateral eye pain, redness, swelling, pain with eye movement, blurred vision, fever, proptosis.
• B. Bilateral mild itching.
• C. Itchy eye with tearing but no vision change.
• D. Discomfort without redness.

Answer: (A)

Orbital cellulitis is an infection that involves the contents of the orbit behind the orbital septum. The best description of its pattern is a unilateral set of eye symptoms with redness and swelling, plus pain when moving the eye, often accompanied by blurred vision and fever, and may include proptosis (the eye protruding). This combination happens because the infection affects the orbital tissues—especially the fat and extraocular muscles—so moving the eye becomes painful, and the swollen tissues can push the globe forward, causing proptosis. The fever reflects a systemic infection and the urgency of the situation, since the orbit is close to the optic nerve and cavernous sinus, and spread can threaten vision or brain structures.

This pattern helps distinguish it from milder surface or eyelid conditions. For example, conjunctivitis or surface irritation can cause redness and discharge but typically lacks significant pain with eye movement, proptosis, and vision changes, and fever is uncommon. Preseptal (periorbital) cellulitis may have eyelid swelling and redness but likewise does not usually produce pain with eye movements, proptosis, or vision disturbance.