Congestion, nasal polyps, rhinorrhea, sinus tenderness. Laboratory - Minimum Lab. Gram stain and Culture for purulent conjunctivitis and orbital cellulitis. CBC with reticulocyte count, blood cultures, urinalysis and culture for orbital or periorbital cellulitis. Differential Diagnosis - Conjunctivitis .
Purulent discharge suggests bacterial conjunctivitis, herpes simplex, or foreign body.
Photophobia, consensual photophobia, pupil constriction and decreased reactivity, ciliary injection, clouding in anterior chamber. Corneal abrasion, foreign body, entropion with conjunctivitis suggest traumatic conjunctivitis. Severe pain, photophobia, irritation, conjunctivitis, and dendritic etching or ulceration on fluorescein examination supports this diagnosis. Purulent conjunctivitis with inflammation of the tear duct with swelling of the medial and inferior lid are found. Swelling and redness of the eye lids and sinus tenderness are seen with periorbital cellulitis.