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Eye swelling (periorbital cellulitis)
Advice for parents or carers taking their child home after seeing a 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.
Symptoms
- Swollen eyelid
- Eye area can be red, tender and warm to touch
- Fever may be present
- May be unable to open their eye
Causes
- Periorbital cellulitis can follow a minor injury to the eye
- It can happen after other infections, such as a cough or cold. The infection can spread to the eye from the sinuses
If your child has any of the following:
- Changes in behaviour
- Difficult to wake up, very sleepy or confused
- Severe headache
- Has a fit (seizure)
- Breathing very fast or breathing that stops or pauses
- Working hard to breathe, drawing in of the muscles below the ribs, unable to talk or noisy breathing (grunting)
- Becomes pale, blue, mottled and/or unusually cold to touch
- Weak, high pitched, continuous cry or extremely agitated
- Develops a rash that does not disappear with pressure and seems unwell (see the 'Glass Test')
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or phone 999
If your child has any of the following:
- The swelling gets worse
- Pain when moving the eye
- Eye appears to stick out or bulge
- Fever gets worse
- Blurred or double vision
- Breathing a bit faster than normal or working a bit harder to breathe
- Complaining of severe pain that is not improving with painkillers
- Dry skin, lips, tongue or looking pale
- Not had a wee or wet nappy in last 12 hours
- Sleepy or not responding normally
- Crying and unsettled
- Poor feeding (babies) or not drinking (children)
You need to contact a doctor or nurse today.
Please ring your GP surgery or call NHS 111 - dial 111
If your child has none of the above:
-
Watch them closely for any change and look out for any red or amber symptoms
Additional advice is also available for families for help cope with crying in otherwise well babies
Self care
Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111
This guidance has been reviewed and adapted by healthcare professionals across West Yorkshire with consent from the Hampshire development groups.
Treatment
Periorbital cellulitis usually improves with antibiotics. Treatment with intravenous (given into a vein) antibiotics is needed for severe cases or those that have not improved with antibiotics given by mouth.
The decision on when to change from intravenous to antibiotics by mouth will be made by the medical team caring for your child. This will depend on how quickly your child responds to treatment. Antibiotics are usually given for 10 days. You can give regular pain relief (paracetamol or ibuprofen) until any pain has improved.
Complications
Most children recover without any complications. However, periorbital cellulitis can sometimes 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 and needs immediate care.
If you are concerned that your child is getting worse, you should contact a healthcare professional urgently.
Things to look out for include:
- The swelling becoming worse
- Pain when moving the eye
- Eye appears to stick out or bulge
- Fever getting worse
- Severe headache
- Blurred or double vision
- Changes in behaviour, such as confusion or disorientation
- Any of the red or amber symptoms above
Call 999 for an ambulance if you have serious concerns for your child.
Prevention
It is not always possible to prevent this infection. However, it is important to have your child fully vaccinated. Two of the bacteria known to cause this infection are covered by the NHS childhood vaccination schedule.
Keep any minor injuries surrounding the eye clean and dry. Remember good hand hygiene before and after cleaning around the eye.
You can treat your child's very minor illnesses and injuries at home.
Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.
Sound advice
Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.
For information on common childhood illnesses go to What is wrong with my child?
You can treat your child's very minor illnesses and injuries at home.
Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.
Sound advice
Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.
For information on common childhood illnesses go to What is wrong with my child?
All community pharmacies across England are required to be Healthy Living Pharmacies. This means that they are able to offer advice on a range of healthy living matters which includes eating a healthy diet. They can provide information leaflets and give parents, carers and young people more information about other organisations that might also be able to help.
Pharmacists are experts in many aspects of healthcare, and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment, and many have private consultation areas. Your pharmacist will say if you need further medical attention.
Sound advice
- Visit a pharmacy if your child is ill, but does not need to see a GP.
- Remember that if your child's condition gets worse, you should seek further medical advice immediately.
- Help your child to understand. Watch this video with them about going to the pharmacy.
For information on common childhood illnesses go to What is wrong with my child?
All community pharmacies across England are required to be Healthy Living Pharmacies. This means that they are able to offer advice on a range of healthy living matters which includes eating a healthy diet. They can provide information leaflets and give parents, carers and young people more information about other organisations that might also be able to help.
Pharmacists are experts in many aspects of healthcare, and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment, and many have private consultation areas. Your pharmacist will say if you need further medical attention.
Sound advice
- Visit a pharmacy if your child is ill, but does not need to see a GP.
- Remember that if your child's condition gets worse, you should seek further medical advice immediately.
- Help your child to understand. Watch this video with them about going to the pharmacy.
For information on common childhood illnesses go to What is wrong with my child?
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns, or to the Community Paediatricians, or the child and adolescent mental health services.
Contact your local Health Visiting Team:
Bradford Health Visitors or call - 01274 221223
Wakefield Health Visitors or call - 0300 373 0944
Craven Health Visitors or call - 01423 544265
Leeds Health Visitors or call - 0113 843 5683
Calderdale Health Visitors or call - 030 0304 5555 (local rate number)
Kirklees Health Visitors or call - 030 0304 5555 (local rate number)
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information about what Health Visitors do: What does a health visitor do?
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns, or to the Community Paediatricians, or the child and adolescent mental health services.
Contact your local Health Visiting Team:
Bradford Health Visitors or call - 01274 221223
Wakefield Health Visitors or call - 0300 373 0944
Craven Health Visitors or call - 01423 544265
Leeds Health Visitors or call - 0113 843 5683
Calderdale Health Visitors or call - 030 0304 5555 (local rate number)
Kirklees Health Visitors or call - 030 0304 5555 (local rate number)
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information about what Health Visitors do: What does a health visitor do?
School nurses care for children and young people, aged 5 to19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and, or emotional health needs.
Contacting the School Nurse
Primary and secondary schools have an allocated school nurse. Phone your child’s school to ask for the contact details of your named school nurse.
There is also a specialist nurse who works with families who choose to educate their children at home.
Contact your local school nursing team:
Bradford School Nurses 01274 221203
Wakefield School Nurses (0 to 19 service) 0300 373 0944 (local rate number)
Leeds School Nurses 0113 843 5683
Calderdale School Nurses 030 3330 9974 (local rate number)
Kirklees School Nurses 0300 304 5555 (local rate number)
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:
- encouraging healthier lifestyles
- offering immunisations
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
School nurses care for children and young people, aged 5 to19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and, or emotional health needs.
Contacting the School Nurse
Primary and secondary schools have an allocated school nurse. Phone your child’s school to ask for the contact details of your named school nurse.
There is also a specialist nurse who works with families who choose to educate their children at home.
Contact your local school nursing team:
Bradford School Nurses 01274 221203
Wakefield School Nurses (0 to 19 service) 0300 373 0944 (local rate number)
Leeds School Nurses 0113 843 5683
Calderdale School Nurses 030 3330 9974 (local rate number)
Kirklees School Nurses 0300 304 5555 (local rate number)
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:
- encouraging healthier lifestyles
- offering immunisations
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.
All children should be registered with a GP. Anyone in England can register for free with a GP surgery. You do not need proof of address or immigration status, ID or an NHS number.
Sound advice
You have a choice of service:
- Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
- Help your child to understand. Watch this video with them about visiting the GP or going to a walk in centre
For information on common childhood illnesses go to What is wrong with my child?
GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.
All children should be registered with a GP. Anyone in England can register for free with a GP surgery. You do not need proof of address or immigration status, ID or an NHS number.
Sound advice
You have a choice of service:
- Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
- Help your child to understand. Watch this video with them about visiting the GP or going to a walk in centre
For information on common childhood illnesses go to What is wrong with my child?
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Please note, the online version of NHS 111 is only recommended for children over the age of 5. If your child is under 5 years old, please phone 111.
NHS 111 can also direct you to your nearest urgent treatment centre (minor injuries unit or walk-in centre).
Sound advice
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Please note, the online version of NHS 111 is only recommended for children over the age of 5. If your child is under 5 years old, please phone 111.
NHS 111 can also direct you to your nearest urgent treatment centre (minor injuries unit or walk-in centre).
Sound advice
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
A&E departments provide vital care for life-threatening emergencies, such as:
- loss of consciousness
- breathing difficulties
- severe bleeding that cannot be stopped
- major trauma such as road traffic collisions
If you’re not sure it’s an emergency, call 111 for advice.
Sound advice
A&E departments provide vital care for life-threatening emergencies, such as:
- loss of consciousness
- breathing difficulties
- severe bleeding that cannot be stopped
- major trauma such as road traffic collisions
If you’re not sure it’s an emergency, call 111 for advice.
Sound advice
