Orbital Disorders

Question 1

Bone that allows sinus infections to spread into the orbit

Answer 1

Medial Wall

Question 2

Thyroid Eye Disease

Answer 2

autoimmune disorder where antibodies affecting thyroid also react against orbital fibroblasts, causing inflammation and fibrosis

Question 3

Signs of Thyroid Eye Disease

Answer 3

inflammation, fibrosis, compression within orbit around optic nerve
results in proptosis

Question 4

Mx of Thyroid Eye Disease

Answer 4

stop smoking
referral to manage thyroid issues
lubricants, lid taping for exposure
systemic steroids
surgery for compressive neuropathy, proptosis, EOMs

Question 5

Presentation of Thyroid Eye Disease

Answer 5

lid retraction, eyes bulging
hyperemia, often around mm insertion
chemosis
EOM issues- most often up gaze

Question 6

Eyelid retraction can cause…..

Answer 6

exposure keratopathy

Question 7

Preseptal Cellulitis

Answer 7

infection of subcutaneous tissues anterior to orbital septum

can spread posteriorly into orbit or cavernous sinus

Question 8

Causes of Preseptal Cellulitis

Answer 8

skin trauma
periocular infection
systemic infection

Question 9

Signs of Preseptal Cellulitis

Answer 9

swollen, firm, tender red eyelid
normal VAs, pupils, EOMs
fever

Question 10

Tx for Preseptal Cellulitis

Answer 10

oral antibiotics

Question 11

Orbital Cellulitis

Answer 11

infection of tissues posterior to orbital septum

sight or life threatening

Question 12

Causes of Orbital Cellulitis

Answer 12

starts in paranasal sinuses

may spread from preseptal cellulitis, dental infection, following trauma, through blood

Question 13

Signs of Orbital Cellulitis

Answer 13

periorbital swelling with marked fever
decreased VAs, color vision
APD
extreme proptosis and chemosis
pain

Question 14

Mx of Orbital Cellulitis

Answer 14

hospitalization

IV antibiotics

Question 15

Nonspecific Orbital Inflammation

Answer 15

not related to infection- idiopathic

swelling causes frozen orbit- eyes move very little

Question 16

Mx of Nonspecific Orbital Inflammation

Answer 16

surgery
steroids
NSAIDs
often resides on its own

Question 17

Dacryoadenitis

Answer 17

inflamed lacrimal gland
swelling w/o bony erosion on CT
S shaped lid

Question 18

Possible causes of Dacryocystitis

Answer 18

thyroid disease
virus/ bacterial infection
Sarcoid
Sjogren

Question 19

Cavernous Sinus Thrombosis

Answer 19

infection originating in sinus or spreading from elsewhere
block of venous drainage causes severe lid edema
ophthalmic vein dilated

Question 20

Tx of Cavernous Sinus Thrombosis

Answer 20

IV antibiotics

anticoagulants

Question 21

Carotid Cavernous Sinus Fistula

Answer 21

compressed internal carotid artery in cavernous sinus
shows tortuous limbal vessels
tortuous vessels and dot-blot hemes on fundus

Question 22

Diagnosing Carotid Cavernous Sinus Fistula

Answer 22

catheter angiography

Question 23

Dacryops

Answer 23

blocked duct from lacrimal gland

Question 24

Mx of Dacryops

Answer 24

surgical removal

Question 25

Dermoid Cyst

Answer 25

keratinized epidermis- growth of ectoderm
skin not swollen
bulging from under lid

Question 26

Sinus Mucocoele

Answer 26

chronic unilateral conjunctivitis

cystic accumulation of mucus in sinus

Question 27

Diagnosis of Sinus Mucocoele

Answer 27

CT scan