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FFP opthalmology > ORbital disease > Flashcards

ORbital disease Flashcards

1
Q

Orbit bones
-Roof

A

Lesses wing of sphenoid
Frontal bone

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2
Q

Lateral wall of orbit

A

Greater wing of sphenoid
Zygomatic bone

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3
Q

Floor or orbit

A

Zygomatic bone
Maxillary
Palatine

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4
Q

Medial wall of orbit

A

Maxillary bone
LAcrimal bone
Ethmoid bone
Sphenoid bone

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5
Q

What is proptosis

A

ABnormal protrusion of the globe

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6
Q

What is pseudoproptosis

A

When it looks like there is proptosis but there isn’t. Due to: high myopia or enophthalmos in the other eye

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7
Q

Causes of proptosis

A

Thyroid eye disease
Tumours
Inflammation
Infection

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8
Q

causes of enopthalmos

A

Small globe
Blow out fractures
Atrophy of orbital content (scleroderma)

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9
Q

What is ophthalmoplegia
Causes

A

Disability or restriction of extra ocular muscles

Tumour, Restrictive myopathy (TED, myositis) and trauma (blow out fractures)

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10
Q

Why can visual acuity be dysfunctional

A

Corneal exposure
Optic nerve compression (also causes changes in colour vision)
Choroidal folds

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11
Q

When can pulsations be seen in the eye

A

AV communication - can be with or without bruit
Defect in the orbital roof (CSF pulsation)- no bruit

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12
Q

What is a bruit a sign of

A

Carotid-cavernous fistula. Heard with bell of stethoscope

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13
Q

What fundus changes can be seen in orbital disease

A

Optic disc swelling
Optic disc atrophy
Choroidal folds- seen in thyroid eye disease and orbital tumours

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14
Q

Thyroid eye disease clinical manifestations

A

Eyelid retraction + periorbital oedema (most common)
Exophthalmos (proptosis)
Diplopia
Exposure keratopathy
soft tissue involvement

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15
Q

What is the cause if diplopia in thyroid eye disease

A

Oedema in active stage and fibrosis in late stage

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16
Q

Complications of orbital cellulitis

A

Optic neuropathy
Abscess formation

17
Q

What is idiopathic orbital inflammatory disease

A

Non-neoplastic, non infectious orbital lesion.
Abrupt painful onset
Unilateral
Periorbital swelling and chemosis
Proptosis
Opthalmoplegia

management: steroids, radiotherapy, cytotoxics

18
Q

Manifestation of orbital venous anomalies (varices)

A

Usually unilateral
Demonstrate intermittent proptosis when doing valsalva manoeuvres

19
Q

What is a direct-cavernous fistula

A

Causes: head trauma, spontaneous rupture.
Ptosis, ophthalmoplegia, raised IO pressure
Can hear a bruit but when compress the carotid on the same side of the face then the bruit disappears

20
Q

What is indirect cavernous carotid fistulas

A

Indirect communication between meningeal branches of internal or external carotids and cavernous sinus

Due to: congenital malformations, spontaneous rupture.

21
Q

Manifestation of indirect cavernous carotid fistulas

A

Dilated episcleral vessels
Raised IO pressure with wide pulsation
Occasional opthalmoplegia and mild proptosis

22
Q

What are encophalaceles

A

Herniation of intracranial contents through congenital skull defects

Causes pulsating proptosis without a bruit

23
Q

Types of tumours which can affect the orbit

A

VAscular
LAcrimal gland
Neural
Miscellaneous

24
Q

What are the commonest tumours in children

A

Capillary haemangiomas - may enlarge on coughing or straining.

25
Q

Treatment of capillary haemangiomas

A

Steroid injections
Local resection

26
Q

What are the most common adult benign orbital tumour

A

cavernous haemangiomas

27
Q

Prognosis and presentation of pleomorphic lacrimal gland adenoma

A

Painless and slow growing. Good prognosis as well encapsulated

28
Q

Presentation of lacrimal gland carcinomas

A

Painful and fast frowing
poor prognosis

29
Q

What is optic nerve glioma
Treatment

A

Typically affects young girls. Associated with neurofibromatosis
Presents with gradual visual loss

OBservation- no growth, good vision and good cosmoses
Excision- poor vision and poor cosmesis
radiotherapy- intracranial extension

30
Q

what is optic nerve meningioma . treatment

A

Middle aged women
GRadual vision loss due to optic nerve compression

Observation- slow growing tumours
Excision- aggressive tumours and poor vision
Radio- slow growing and good vision

31
Q

Common primary sites of tumours which can affect the eye

A

Breast, bronchus, prostate, skin, GI and kidney

FFP opthalmology (6 decks)

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