What systemic symptom is often absent in preseptal cellulitis?

In preseptal cellulitis, fever is often absent, especially in the early stages of the infection. Preseptal cellulitis affects the eyelid and surrounding tissues without involving the deeper structures of the eye, such as the orbit. As a result, patients may present with localized swelling, redness, and tenderness of the eyelid, without systemic symptoms such as fever.

In contrast, other systemic symptoms like ophthalmoplegia, pain with eye movements, and vision impairment are more closely associated with orbital cellulitis, which is a more severe condition that affects the orbit and can lead to complications such as abscess formation or vision loss. Therefore, while preseptal cellulitis can present with localized symptoms, systemic manifestations like fever may not be present, making it a distinctive feature in differentiating it from more serious infections like orbital cellulitis.