A series of 18 children with orbital infection secondary to sinusitis is described. The presenting symptoms were headache and periorbital swelling but it was found to be impossible to determine the stage of the orbital infection on clinical grounds. CT scanning can accurately identify the presence of a sub-periosteal abscess but both axial and coronal sections may be needed to diagnose abscesses in the superomedial portion of the orbit. Cellulitis may be managed by antibiotic treatment alone, but if an abscess is present it should be drained immediately with a formal ethmoidectomy to decompress the orbit if there is any evidence of reduced visual acuity.
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