The Orbit

Question 1

how can this be diagnosed?

Answer 1

• anytime someone comes with sudden onset of double vision think about extrinsic ocular muscles and ask them to move their eyes to see if movement is limited
• left eye is abnormal - elevation is not able to happen
• superior rectus and inferior oblique are innertvated by CN III
• medial bone and floor of orbit is weak - blunt force can cause orbit to explode at the medial wall or floor of orbit and contents of orbit herniate there
• this guy has a blow out fracture as the floor of the orbit is fractured and the muscles there are thethered in the orbital fracture
• diagnosed by imaging - CT

Question 2

what signs would yiou look for in a orbital floor fracture?

Answer 2

• the orbital floor fracture causes herniation into maxillary sinus

- teardrop sign

- cotton bud sensation on damaged eye is lost

Question 3

in what diseases can orbita fat hypertrophy? what does this lead to?

Answer 3

thyroid disease

autoimmune disease

• pushes eyeball out to give staring appearence

Question 4

Answer 4

• abnormal positon of the eyelids = scleral show

Question 5

what is proptosis?

Answer 5

where the eyeball is protuding out of the orbit a little more than normal

Question 6

Answer 6

• optic nerve disc is hazy and blood vessels (especially veins) are dilated - fundus looks like its choking
• rare
• infection of cavernous sinus
• venous drainage was blocked and that is why she had swollen eyes - pressure will eventually affect central retinal artery which can lead to total blindness
• if not isentified early infection could spread to intracranial venous sinuses and resulted in death