Disease 6-8 - Orbital Disorders
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What is orbital mucormycosis?
fungal infection of the sinuses
What is orbital cellulitis?
infection behind orbit
Sx and Tx of orbital cellulitis?
- fever, acute, unilateral, edema, redness, warmth, painful ophthalmoplegia ON dysfuntion
- hospital, antibiotics, ct scans
idiopathic orbital inflammatory disease
Sx of IOID
uni, swelling, chemosis, acute, proptosis, ophthalmoplegia
Tx of IOID?
What is TED?
- autoimmune, hyperthyroidism
- infallmation of EOM and orbital tissue
sx and TED?
- grittiness, photophobia, diplopia, vf defects
- 1. Soft tissue- swelling, conj hyperaemia, chomosis
- 2. eyelid retraction- primary gaze, delayed in downgaze
- 3. Proptosis- prevents eye closure- steroids
- 4. optic neuropathy- compression of ON or blood supply by EOM muscles
- 5. Ocular motility- diplopia
tx of TED?
lubricants, eyelid taping, steroids, surgical decompression, botox
- unilateral painless proptosis
- located within muscle cone
- surgical excision
What is an orbital varices?
- low pressure/flow, thin walled vessel
- engorgement can occur via increased venous pressure
What is a direct carotid- cavernous fistula
- intracavernous part of internal carotid
- trauma cause
- flow shunt
- sx: ptosis, ophthal, raised IOP, haemorrhages
- tx: surgery, resolves
What is an indirect carotid cavernouse fistula
- benign vascular formation
- early childhood
- surgical treatment
What is a superficial dermoid cyst?
- no displacement of globe
- mobile under skin
What is a deep dermoid cyst?
- obstruction of drainiage of sinus secretions
- gradual proptosis or globe displacement
herniation of csf through congenital skull defect
herniation only involving dura
- inflammation of lacrimal sac folllowing blockage
- tx: antibiotics and warm compresses
What is a dacryoadenitis?
- inflammation of lacrimal gland
- sx: warmth, upper lid swelling S SHAPE, warmth, tenderness
Adenoid cystic carcinoma?
- epithelial tumor of lacrimal gland
- f>m, 4th
- exophthalmos, downward globe displacement, ptosis, diplopia, orbital pain
what is an optic nerve glioma?
- optic nerve sheath tumor
- childhood, slow, benign
- proptosis,visual loss, optic atrophy
What is a lymphoma?
- 6th-8th lymphoid lesions
- slow onset, anywhere in globe
- tx: radio/chemotherapy
- most common orbital malignancy- superonasal
- sx: proptosis, swelling mass, ptosis, injection
- tx: radio/chemo
- ddx: oribtal: NOT warm
- 80% arise from optic nerve sheath
- PAINLESS, decreased VA, proptosis
3 main types of lacrimal gland tumours?
- lymphoid/psuedo tumours- 50%
- pleomorphic adenoma- 25%
- malignant- 25%
What is a pleomorphic lacrimal gland adenoma?
- benign- adult
- epithelial tumour of lacrimal gland- orbital lobe
- sx: painless, proptosis, ophthalmoplegia, slow progression
- tx: excision
What are the 3 types of malignant lacrimal gland tumours?
- pleomorphic adenocarcinoma- 20%
- adenocystic carcinoma- 60%
- mucoepidermoid carcinoma- 20%
What is an adenoid cystic carcinoma?
Most common tumor to spread to the orbit?
- rare childhood oribal metastases
- sx: abrupt, bilateral, ptoptosis, superior orbital mass, raccoon eyes
- childhood orbital metastases
- localised tumour of myeloid cells
- rapid prop, lie edema, ecchymosis,
Langerhans cell granulomatosis?
- VERY RARE child orbital metastases
- may destroy orbital bone via imflammatory lesions
- maxillary: most common, face pain and swelling, nasal discahrge, nosteplead, dystopia, epiphora, diplopia
- ethmoidal: lateral dystopia
- nasopharyngeal: poptosis
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