Orbit, Eyelids, Lacrimal 4

Question 1

Dacrocystitis

Answer 1

1. Complete nasolacrimal obstruction

2. Chronic stasis is risk for infection

Question 2

Causes of Dacrocystitis

Answer 2

1. Staph, strep and diptheroids frequently infect

2. Gram negatives in diabetic and immune compromised patients

Question 3

Dacrocystitis treatment

Answer 3

Insert prosthetic drain via bypass

Question 4

Pre-septal cellulitis

Answer 4

Infection of skin around eye, anterior or orbital septum

Question 5

Pre-septal cellulitis treatment

Answer 5

1. Treat with oral antibiotics and nasal decongestants

2. In adults and teenagers, adjunct warm compresses

Question 6

Orbital Cellulitis

Answer 6

1. Infection posterior to orbital septum

2. Usually due to sinusitis

Question 7

Orbital Cellulitis

signs

Answer 7

1. Fever
2. leukocytosis
3. proptosis
4. chemosis
5. ptosis
6. Decreased visual acuity, color, visual field

Question 8

Orbital Cellulitis

treatment

Answer 8

1. TREAT AGGRESIVELY
2. Many foramina allow spread to brain structures
3. Delay can result in blindness, thrombosis of canvernous sinus and brain abscess

Question 9

Thyroid eye disease is an _____.

Answer 9

autoimmune disorder associated with Grave’s disease.

Question 10

Thyroid eye disease signs

Answer 10

1. eyelid retraction (most common sign)
2. lid lag
3. proptosis
4. restrictive myopathy
5. compressive optic neuropathy.

Question 11

Thyroid eye disease pathogenesis

Answer 11

1. via orbital fibroblasts that have CD40 receptors.
2. These receptors induce synthesis of glycosaminoglycans (GAGs) which are responsible for the symptoms of thyroid eye disease.

Question 12

Thyroid eye disease treatment

Answer 12

1. treat the thyroid problem so that a normal thyroid level is achieved.
2. Most patients only require supportive care as once the thyroid is normal, they eye disease is self limited.

Question 13

Thyroid eye disease, blindness can occur if

Answer 13

there is sufficient congestion in the orbit to choke the optic nerve.

In these cases, decompression surgery is warranted to remove bone around the orbit and give the nerve more space.