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Opthalmology > Orbital Disease > Flashcards

Orbital Disease Flashcards

1
Q

what are the bones of the orbit

A 
Frontal 
Spehnoid
zygomatic 
maxillary
palatine
lacrimal
ethmoid
`
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2
Q

what bones make up the roof of the orbit

A

Frontal bone

Lesser Sphenoid wing

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3
Q

what bones make up the lateral wall of the orbit

A

zygomatic

greater sphenoid

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4
Q

what bones make up the floor of the orbit

A

zygomatic
maxillary
palatine

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5
Q

what bones make up the medial wall of the orbit

A

maxillary
lacrimal
ethmoid
sphenoid

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6
Q

what causes proptosis

A

thyroid eye disease
tumours
inflammation
infection

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7
Q

what is enopthalmos

A

globe recession into the prbit

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8
Q

what causes enopthalmos

A

structural abnormalities - blow out fracture
small globe
atrophy of orbital contents - irridation/scleroderma

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9
Q

what is opthalmoplegia

A

restriction/disability of ocular muscles

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10
Q

what causes opthalmoplegia

A

tumours
myopathy
CN3 lesions
Trauma

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11
Q

what is thyroid eye disease

A

autoimmune disorder where thyroid autoantibodies react with extraocular tissue to cause a variety of symptoms

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12
Q

what are symptoms of thyroid eye disease

A 
exopthalmos (1/3) 
periorbital odema
lid lag
diplopia (10%) 
rarely - CN3 compression, optic neuropathy
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13
Q

what is orbital cellulitis

A

infection behind orbital septum

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14
Q

whats orbital cellulitis usually secondary to

A

ethmoiditis

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15
Q

what are symptoms of orbital cellulitis

A

severe malaise, fever, orbital swelling/redness/ptosis/painful opthalmoplgeia/CN2dysfunction

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16
Q

what are complications of orbital cellulitis

A

CN2 neuropathy
abscess formation
secondary cranial cavity infection

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17
Q

what is idiopathic orbital inflammatory disease

A

non-neoplastic non-infectious orbital lesion
20-50%
usually abrupt
causes proptosis, chemosis, periorbital swelling

18
Q

how do you diagnose idiopathic orbital inflammatory disease

A

when everything else has been ruled out - diagnosis of exclusion

19
Q

what type of disease are orbital varicies

A

congenital

20
Q

what is a common symptom of orbital varicies

A

intermittent proptosis accentuated by the valsava

21
Q

what is a direct carotid-cavernous fistula

A

abnormalcommunication between the carotid artery and the cavernous sinus (venous dural sinus)

22
Q

what are features of a direct carotid-cavernous fistula

A 
ptosis
opthalmoplgeia
chemosis 
conjunctival injection 
raised IOP 
pulsatile proptosis with thrills
23
Q

what are causes of a direct carotid-cavernous fistula

A

Trauma

Rupture

24
Q

what is an indirect carotid-cavernous fistula

A

abnormal indirect communication between the meningeal branches of the ICA and the carotid sinus

25
Q

what is the presentation of an indirect carotid-cavernous fistula

A

dilated eipscleral vessels
raised IOP
occasional opthalmoplegia
mild proptosis

26
Q

what is encephalocele

A

herniation of intracranial contents through a congenital skull defect

27
Q

what are the 4 types of orbital tumours found + their subtypes

A

vascular - capillary/cavernous haemangioma

lacrimal gland - pleomorphic adenoma

neural - CN2 glioma, CN2 sheath meningoma

misc - mets/invasion from sinus

28
Q

what is the most common orbital tumour in children

A

capillary haemangioma

29
Q

at what point in time do capillary haemoangiomas present in children

A

30% at birth , 100% by 6 month

30
Q

what systemic complications are capillary haemoangiomas associated with

A

high output cardiac failure

maffuci syndrome

31
Q

what’s the prognosis of capillary haemangiomas

A

70% resolve by 7 years old

steroids and local resection used when possible

32
Q

whats the most common orbital tumour in adults

A

cavernous haemangioma

33
Q

what is the epidemiology of orbital tumours

A

F>M 40-60 y/o

34
Q

how do you treat orbital tumour

A

Surgical Excision

35
Q

what are features of pleomorphic lacrimal adenoma

A

30-40
painless
slow growing
can be surgically removed

36
Q

what are features of lacrimal carcinoma

A

30-50
poor prognosis
rapid growing

37
Q

how do you treat lacrimal carcinoma

A

surgery/radiotherapy

38
Q

what are features of CN2 Glioma

A

F>M
usually young
associated with NF1
7-10 first present with gradual visual loss
slow growing
excision done if affecting vision or cosmetics

39
Q

what are features of CN2 sheath meningoma

A

middle aged women
gradual visual loss due to CN2 compression
Tx = excision + radiotherapy

40
Q

how do you manage orbital cellulitis

A

Systemic Abx
CN2 monitoring
Surgery

41
Q

what are the conditions for surgery in orbital cellulitis

A

antibiotic resistance
abscesses
optic neuropathy

42
Q

how do you treat idiopathic inflammatory orbital disease

A

mild = no Tx

prolonged intermittent activity with eventual remissions = steroids, radiotherapy, cytotoxic usage

severe, prolonged = frozen orbit

Opthalmology (16 decks)

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