Orbital Disease Flashcards
Orbital roof
Frontal bone
Lesser wing of the sphenoid
Lateral wall of the orbit
Greater wing of the sphenoid bone
Zygomatic zone
Medial wall of the orbit
Ethmoid bone
Lacrimal bone
Lesser wing of the sphenoid
Tip of maxilla
Orbital floor of the orbit
Maxilla
Zygomatic
Palatine
Things that pass through the optic canals
Optic nerve and the ophthalmic artery
Things that pass through the superior orbital fissure
CN III, IV, VI, superior ophthalmic vein, ophthalmic nerve (frontal and lacrimal),
Inferior orbital fissure things
Maxillary nerve (V2)
SO muscle origin
Lesser wing of sphenoid
Only muscle that originates from the anteiror orbit
IO
IO origin
Anteiror portion of the orbit on the maxilla
Symptoms of neuro-ophthalmology of orbital disease
Vision loss, double vision, non-comitant strab, swelling, ptosis, proptosis, enophthlamos, facial hypesthesia (CN V), loss of VF
Optic disc findings of neuro-ophthalmology orbital disease
Optic nerve atrophy (later stage)
Optic disc swelling
Retinal findings of neuro-op orbital disease
- venous engorgement or impending venous occlusion
- maybe seen with optic nerve tumors, but us very rare in patients with inflamamtory disease of the orbit
- choroidal folding
Eye movement abnormalities in neuro-op orbital disease
Mixed pattern of eye movement abnormalities
3 major forms of imaging for neuro orbital diseases
Echography (A scan/ B scan)
CT scan
MRI scan
Key diffrence between CT and MRI
CT used to scan bones
Can only use CT if they have a pace maker
Orbital inflamamtion
Graves orbitopathy Idiopathic inflamamtory syndrome (orbital pseudotumor) -posterior scleritis -diffuse inflammation -myositis -dacryoadenitis -perineuritis -sclerosing orbital inflamamtion Other inflammatory orbital conditions -granulomatous orbital inflammation -sarcoidosis -Wagner’s granulomatosis -Polyarteritis nodosa -histiocytic disorders
Onset of idiopathic orbital inflammatory syndrome (orbital pseudotumor)
Acute onset of proptosis and eyelid swelling associated with pain and double vision
Signs and symptoms of idiopathic orbital inflammatory syndrome (orbital pseudotumor)
- acute onset proptosis and eyelid swelling associated with pain and double vision
- usually conjunctival swelling (chemosis), injection, and eyelid erythema
Cause of idiopathic orbital inflammatory syndrome
Unknown, maybe include viral, allergic and AI mechanisms
How common is idiopathic orbital inflammatory syndrome
Uncommon
Who can get idiopathic orbital inflammatory sybdrome
Can occur at any age, with most patients presenting in middle life. No sex/ race predilection
How to confirm idiopathic orbital inflammatory syndrome
Echography, MRI or CT
Biopsy usually deferred unless the inflammation is recurrent, atypical in appearance, or primarily involved the lacrimal gland