AOC: The orbit Flashcards
What is thyroid eye disease?
what are the signs of thyroid eye disease?
definition: organ specific autoimmune reaction in which the igG antibody produces inflammation and swelling of orbital tissue especially the extra ocular muscles.
signs: SEPOR
- soft tissue involvement
- eyelid retraction
- proptosis
- optic neuropathy
- restrictive myopathy
What are the effects of soft tissue involvement in throid eye disease?
5 effects (3 swelling, 1 hyperaemia, 1SLK)
- lid swelling
- periorbital swelling
- conjunctival swelling ie chemosis
- conjunctival hyperaemia
- superior limbic keratoconjunctivitis
what is proptosis?
abnormal protrusion of one or both eyeballs.
what are treatments of the proptosis?
- surgical decompression
- steroids (since throid eye disease involving inflammation and swelling of orbital tissue, thus steroid is used to reduced the swelling)
- radiotheraphy (same tratment as the medium retinoblastoma ie locally applied radiotheraphy, beam radiotheraphy and chemotheraphy)
what are the signs of optic neuropathy (one of the sign for thyroid eye disease)?
- 5% of pxs
- early defective color vision
- may not have significmant proptosis
- usually normal disc appearance but may have swollen disc
what are the signs of restrictive myopathy?
anticlockwise that start with 6 oclock: IR: defect of elevation most commonly LR: abduction SR: depression MR: adduction
what is the abnormal conditions of the orbit?
T3i2v
Thyroid eye disease Tumours Trauma Infection Inflammation Vascular lesions
What are the signs and symptoms of orbital cellulitis (infection in the orbit)?
- infection behind orbital septum
- cellulitis means infection of the deeper layers of the skin usually by streptococcus bacteria. - usually secondary to ethmoiditis (ethmoiditis: inflammation of the ethmoidal cells in the sinuses, the air-filled cavity between eyes and behind the nose)
- present with severe malaise, fever and orbital signs including
- restricted eye movement or painful ophthalmoplegia (paralysis or weaknesses of the eye muscle)
- proptosis
- severe eyelid oedema and redness
- optic nerve dysfunction (have 6 other symptom)
What are the signs of optic nerve dysfunction?
- VA reduction
- RAPD
- dyschromatopsia (red-green)
- dimished light brightness sensitivity
- diminished contrast sensitivity
- VF defect
what are the complications of orbital cellulitis?
IOP: raised IOP Volk: -optic neuropathy -retinal vascular occlusion MRI: -abscess brain -abscess orbit -cavernous sinus thrombosis
what are the management of orbital cellulitis?
admit to hospital: urgent referral (referral within two weeks to HES)
- systemic antibiotics
- monitor optic nerve function
- surgery if (resistance to antibiotics, orbital or subperiosteal abscess, optic neuropathy)
Describe da-cry-oade-nitis?
Da-cry-oade-nitis is the infection of the lacrimal gland.
- usually affects otherwise healthy individuals
- presents with acute discomfort of lacrimal glands
What are the signs of dacryoadenitis?
- odema of lateral aspect if top lid
- mild downward displacement and inward globe displacement
- injection and tenderness of palpebral lope of lacrimal gland
- reduced tears
what is idiophatic orbital inflammatory disease?
- pseudotumours
- non infectious orbital lesions
- involves any/all soft tissues
- present 20-50years of age
- usually unilateral
- periorbital swelling and chemosis
- proptosis (same as orbital cellulitis)
- ophthalmoplegia (same as orbital cellulitis)
what are the treatments for idiophatic orbital inflammatory disease?
wait- it may resolve spontaneously but if prolonged: -give steroids -radiotheraphy -cytotoxics (in vase resistance to steroids and cytotoxics)
