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Difference Between Blepharitis and Preseptal Cellulitis

Blepharitis is when the eyelid is inflamed. Preseptal cellulitis is when a tissue infection develops around the eye.

What is Blepharitis?


Blepharitis is an inflammatory response that occurs on the eyelid and can occur either as an acute or chronic condition.

Causes and prevalence:

The causes of blepharitis include bacterial infection and dandruff. The acute form of blepharitis is usually a result of Staphylococcus bacteria while chronic blepharitis is more often associated with seborrheic dermatitis (dandruff). Allergies and a condition known as meibomian gland dysfunction can also cause blepharitis in some people. Blepharitis is common in the population with about 37% to 47% of people having this condition at some stage of their lives.

Symptoms and complications:

The symptoms of blepharitis include the following: red eyelids that are sore, swollen, and itchy. Crusts may be visible on the eyelids and you likely also have dry eyes. Your eyes may be itchy and burning and the eyelids may be oily, if not crusty. 


Diagnosis is done by means of a split-lamp exam, which is completed by an ophthalmologist.


The treatment depends on the cause of the condition and if it is the acute or chronic form. Treatment may include using antibiotic ointments such as bacitracin, antiviral medicines, and also corticosteroid ointments.

What is Preseptal cellulitis?


Preseptal cellulitis is an infection that affects the tissue and skin of the face that occurs below the eye (in front of the orbital septum) and that also affects the eyelid. 

Causes and prevalence:

This condition can be due to a bite from an animal or insect. It can also be due to conditions like sinusitis, chalazion, bacteria such as Streptococcus pneumoniae, or injuries to the face or eyelid. Preseptal cellulitis is quite common in children under 10 years of age.

Symptoms and complications:

The symptoms of preseptal cellulitis include a swollen eyelid that is also painful and red. It may be discolored and there may be a fever. It may also be hard for the person to open their eye due to the swelling. Dangerous complications can occur including orbital cellulitis, brain abscess, meningitis, or cavernous sinus thrombosis.


Diagnosis is based on the physical symptoms but a CT scan or MRI may be needed if there is a chance orbital cellulitis is occurring and to rule out this condition.


Treatment involves using antibiotics like clindamycin or doxycycline to kill of the bacteria that are causing the infection.

Difference between Blepharitis and Preseptal cellulitis?


Blepharitis is inflammation of the eyelid due to blocked oil glands. Preseptal cellulitis are infection of tissues that are found around the eye.


Demodex mites, bacteria, viruses, meibomian gland dysfunction, dandruff, and allergies are all potential causes of blepharitis. Bacterial infection and insect or animal bites, chalazion, sinusitis, and face or eyelid injury, are all potential causes of preseptal cellulitis.


In the case of blepharitis, the symptoms include dry eyes, redness, pain, itching, and swelling of the eyelid, a crust may form or the eyelid may be greasy in appearance. In the case of preseptal cellulitis, the symptoms may include swollen, red, and sore eyelid, discolored areas of skin below the eye, and fever.


Complications of blepharitis include scarring of the tissues, corneal injury, loss of eyelashes, chalazion formation, and stye. Complications of preseptal cellulitis include permanent loss of sight, orbital cellulitis, brain abscess, meningitis, or cavernous sinus thrombosis.


Treatment of blepharitis includes using antibiotics, antivirals, and corticosteroid ointments. Treatment of preseptal cellulitis includes using antibiotics.

Age of onset

Blepharitis can occur at all ages but is most often diagnosed in people over 50. Preseptal cellulitis is a common problem found in children under 10 years of age. 

Table comparing Blepharitis and Preseptal cellulitis

Summary of Blepharitis Vs. Preseptal cellulitis

  • Blepharitis is a condition where the eyelid is inflamed.
  • Preseptal cellulitis is a bacterial infection of the eyelid and tissue of the face below the eye.
  • Both preseptal cellulitis and blepharitis can be dangerous and should be treated rapidly.


What is the difference between periorbital cellulitis and blepharitis?

Periorbital cellulitis is another name for preseptal cellulitis. It is an infection of the tissues around the eye. Blepharitis is an inflammation of oil glands found on the eyelid.

How can you tell the difference between preseptal cellulitis and blepharitis?

Preseptal cellulitis includes inflammation of the part of the skin below the eye while blepharitis is more limited to the eyelid. There is also a difference in age of diagnosis of the two conditions.

Is cellulitis a blepharitis?

It is not the same, but cellulitis can develop from blepharitis that is untreated.

How do you rule out preseptal cellulitis?

A CT scan is needed to tell the difference sometimes between preseptal cellulitis and other conditions that cause eyelid swelling.

Should I go to the ER for periorbital cellulitis?

Yes, any infection around the eye can have serious complications and so a trip to the ER is a smart move.

What is the first line for periorbital cellulitis?

Antibiotics that are the first choices for treating periorbital cellulitis include Cefpodoxime or Clindomycin.

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References :

[0]Allen, Richard C. “Preseptal and orbital cellulitis (periorbital cellulitis)”. Merckmanuals. Merck & Co., 2022, https://www.msdmanuals.com/professional/eye-disorders/orbital-diseases/preseptal-and-orbital-cellulitis

[1]Fromstein, Stephanie R., et al. "Demodex blepharitis: clinical perspectives." Clinical Optometry (2018): 57-63.

[2]Garrity, James. “Blepharitis”. Merckmanuals. Merck & Co., 2022, https://www.msdmanuals.com/professional/eye-disorders/eyelid-and-lacrimal-disorders/blepharitis

[3]Image credit: https://www.canva.com/photos/MAEQfVntZ8g-male-patient-with-blepharitis/

[4]Image credit: https://www.canva.com/photos/MAEbAC699Tk-close-up-stye-hordeolum-chalazion-macro-detail-of-an-eye-infection-/

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