Disease 6-8 - Orbital Disorders
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Disease 6-8 - Orbital Disorders
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?
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
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
: ptosis, ophthal, raised IOP, haemorrhages
: surgery, resolves
What is an indirect carotid cavernouse fistula
benign vascular formation
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
: antibiotics and warm compresses
What is a dacryoadenitis?
inflammation of lacrimal gland
: warmth, upper lid swelling S SHAPE, warmth, tenderness
Adenoid cystic carcinoma?
epithelial tumor of lacrimal gland
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
most common orbital malignancy- superonasal
: proptosis, swelling mass, ptosis, injection
: 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%
What is a pleomorphic lacrimal gland adenoma?
epithelial tumour of lacrimal gland- orbital lobe
: painless, proptosis, ophthalmoplegia, slow progression
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
: 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
: most common, face pain and swelling, nasal discahrge, nosteplead, dystopia, epiphora, diplopia
: lateral dystopia