Wald ER: Periorbital and Orbital Infections. Pediatrics in Review 2004; 25(9): 312-319.
The most common cause of eye swelling in children is due to noninfectious blunt trauma, which leads to the "black eye." The swelling around the eye generally increases for 48 hours, requires no treatment, and usually resolves over several days. This article reviews pathogenesis of the eye disorders, diagnosis, and management of several conditions causing eye pain and swelling. The anatomical relationship of the eye orbit and facial sinuses leads to increased susceptibility for spread of infection from several directions.
Preseptal infections such as conjunctivitis, hordeolum, dacryoadenitis, dacryocystitis, bacteremic periorbital cellulitis, and preseptal cellulitis vary in management from simple topical treatment for conjunctivitis to hospitalization and therapy with parenteral antibiotics. Orbital infections are frequently due to sinusitis and may involve the formation of a subperiosteal abscess. Depending on imaging studies, these infections may require surgical drainage and antimicrobial therapy.