Upload
charles-casey
View
216
Download
0
Tags:
Embed Size (px)
Citation preview
Preseptal Cellulitis
Infection anterior Infection anterior to the orbital to the orbital septumseptum
Swelling, ptosis, Swelling, ptosis, warmthwarmth
(-) Pain, (-) (-) Pain, (-) congestioncongestion
Orbital Cellulitis
Infection posterior Infection posterior to the orbital septumto the orbital septum
Fever, pain on eye Fever, pain on eye movement, decreased movement, decreased VA, EOM restrictions, VA, EOM restrictions, proptosisproptosis
Most common cause – Most common cause – sinus infection sinus infection (ethmoid sinusitis)(ethmoid sinusitis)
Thyroid Eye Disease / Grave’s Ophthalmopathy
Female, 30s-40sFemale, 30s-40s
#1 cause of proptosis#1 cause of proptosis
Autoimmune diseaseAutoimmune disease
Thickening of EOMs Thickening of EOMs proptosis & upper lid proptosis & upper lid retractionretraction
Exophthalmometry norm Exophthalmometry norm for Caucasians: 12-for Caucasians: 12-22mm22mm
Carotid-Cavernous Fistula (CCF)
Abnormal artery-vein Abnormal artery-vein communicationcommunication
#1 cause – trauma#1 cause – trauma
Chemosis, pulsatile Chemosis, pulsatile proptosis, ocular bruitproptosis, ocular bruit
Cavernous sinus: Cavernous sinus:
3, 4, 6, V1, V23, 4, 6, V1, V2
V3 & 7 do not go V3 & 7 do not go throughthrough
Orbital Tumors
Cavernous hemangiomaCavernous hemangioma
Capillary hemangiomaCapillary hemangioma
RhabdomyosarcomaRhabdomyosarcoma
NeuroblastomaNeuroblastoma
Optic nerve gliomaOptic nerve glioma
MeningiomaMeningioma
LymphomaLymphoma
NeurofibromaNeurofibroma
Neurilemma Neurilemma (Schwannoma)(Schwannoma)
Lymphoma
50s-60s50s-60s
Proptosis in older patients (younger Proptosis in older patients (younger patients, think TED)patients, think TED)
Orbital Pseudotumor
IdiopathicIdiopathic
Inflammation of the Inflammation of the orbitorbit
Unilateral painful Unilateral painful proptosisproptosis
Unilateral chemosis Unilateral chemosis (allergy would be (allergy would be bilateral)bilateral)
Tolosa-Hunt Syndrome
IdiopathicIdiopathic
Inflammation of the orbitInflammation of the orbit
Bilateral painful proptosisBilateral painful proptosis
Eyeball Abnormalities
Phthisis bulbiPhthisis bulbi
AnophthalmosAnophthalmos
MicrophthalmosMicrophthalmos
EnophthalmosEnophthalmos
Phthisis bulbi
Small globe Small globe (atrophy)(atrophy)
Causes – disease, Causes – disease, trauma, infection, trauma, infection, surgerysurgery
Blind eyeBlind eye
Ocular prosthesis
Enucleation – remove Enucleation – remove globeglobe
• Evisceration – Evisceration – remove contents remove contents within sclerawithin sclera
• Exenteration – Exenteration – remove orbital remove orbital contents (globe, contents (globe, EOMs, fat)EOMs, fat)
Ocular Rosacea
• Chronic ocular Chronic ocular surface diseasesurface disease
• Sebaceous glandsSebaceous glands
• Middle-ageMiddle-age
• Telangiectasia, Telangiectasia, rhinophyma, rhinophyma, malar/butterfly rashmalar/butterfly rash
Contact Dermatitis
• Type 4 Type 4 hypersensitivityhypersensitivity
• 24-72 hour delay24-72 hour delay
• Ex: cosmetics & medsEx: cosmetics & meds
• Acute redness, Acute redness, swelling, chemosisswelling, chemosis
Ocular Cicatricial Pemphigoid• Systemic mucous Systemic mucous
membrane disordermembrane disorder
• IdiopathicIdiopathic
• Signs – Signs – symblepharon, symblepharon, ankyloblepharonankyloblepharon
Stevens-Johnson Syndrome• Type 3 Type 3
hypersensitivityhypersensitivity
• Mucous membrane Mucous membrane disorderdisorder
• #1 cause – drug-#1 cause – drug-induced (sulfonamides)induced (sulfonamides)
• Prodrome – flu-likeProdrome – flu-like
• PseudomembranesPseudomembranes
• SymblepharonSymblepharon