To the Editor:

Preferred imaging strategies for a variety of pathologies were presented by Othman et al. [1], including for the investigation of orbital cellulitis. For this, the authors suggest that the imaging of choice is orbital CT scan. Given that orbital cellulitis occurs most commonly secondary to sinusitis, both in paediatric [2] and adult populations [3], I consider sinus and orbital CT superior to orbital CT alone.

In cases of orbital cellulitis, I have been obliged to request sinuses CT, following on from an initial orbits CT that confirmed orbital cellulitis and showed signs of sinus pathology, but that did not show the sinuses adequately for pre-operative planning for sinus surgery. This repeated scanning increases the radiation dose, often in a paediatric population, and can delay definitive management in cases where surgery is required.