DEPARTMENT OF OPHTHALMOLOGY DEPARTMENT OF OPHTHALMOLOGY

PESHAWAR MEDICAL COLLEGE,PESHAWAR MEDICAL COLLEGE,

PESHAWAR.PESHAWAR.

Dr. Muhammad ArifDr. Muhammad Arif

Assistant ProfessorAssistant Professor

Department of Ophthalmology Department of Ophthalmology

ORBITORBIT

BONY CAVITIES IN THE SKULL CONTAININGBONY CAVITIES IN THE SKULL CONTAINING GlobesGlobes EOMEOM Nerves Nerves Vessels Vessels FAT pads FAT pads Lacrimal gland Lacrimal gland PeriorbitaPeriorbita Orbital septum Orbital septum

Orbital DimensionOrbital Dimension Volume Volume 30cc30cc

Entrance height Entrance height 35mm35mm

Entrance widthEntrance width 40mm40mm

Medial wall length Medial wall length 45mm45mm

Distance from Distance from posterior globe to posterior globe to optic foramenoptic foramen

18mm18mm

Length of orbital Length of orbital segment of optic segment of optic nervenerve

25-30mm25-30mm

Orbital anatomy Orbital anatomy

Floor Floor Roof Roof Lateral wallLateral wall Medial wallMedial wall

Developmental defects Developmental defects

MicrophthalmosMicrophthalmos AnophthalmosAnophthalmos CcphalocclesCcphaloccles

Evaluation of orbital Evaluation of orbital diseases diseases

Detail historyDetail history OnsetOnset Duration of symptomsDuration of symptoms InjuryInjury Prior disease Prior disease Systemic diseaseSystemic disease Family historyFamily history

Course of symptoms Course of symptoms

PainPain ProptosisProptosis ProgressionProgression PalpationPalpation PulsationPulsation Periorbital changes Periorbital changes

Examination Examination

Visual acuityVisual acuity RefractionRefraction Color visionColor vision PupilsPupils Extraocular motilityExtraocular motility Anterior segmentAnterior segment Posterior segmentPosterior segment Eyelids Eyelids

Tools of examination Tools of examination

ExophthalmometryExophthalmometry CT Scan orbit in brain CT Scan orbit in brain MRIMRI Orbital sonographyOrbital sonography Orbital endoscopy Orbital endoscopy

Preseptal cellulitisPreseptal cellulitis

Preseptal cellulitis is defined as Preseptal cellulitis is defined as inflammation and infection confined inflammation and infection confined to the eyelids and periorbital to the eyelids and periorbital structures anterior to the orbital structures anterior to the orbital septum.septum.

Organism causing Organism causing

Haemophilus influenzaeHaemophilus influenzae Gram-positive cocciGram-positive cocci Staphylococcus aureus Staphylococcus aureus

Investigations Investigations

History History Clinical examinationClinical examination Blood completeBlood complete Bacteriological examinationBacteriological examination

Treatment Treatment

Antibiotics Antibiotics AnalgesicsAnalgesics Surgical drainage Surgical drainage

Orbital cellulitis Orbital cellulitis

Active infection of the orbital soft Active infection of the orbital soft tissue is present posterior to the tissue is present posterior to the orbital septum. orbital septum.

SymptomsSymptoms FeverFever LeukocytosisLeukocytosis ProptosisProptosis Restriciton of ocular motility Restriciton of ocular motility Pain on movement of the globePain on movement of the globe

causescauses

Paranasal sinusesParanasal sinuses Face and eyelidsFace and eyelids DacryocystitisDacryocystitis Dental infectionDental infection Intracranial Intracranial Trauma Trauma DacryoadenitisDacryoadenitis EndophthalmitisEndophthalmitis

Treatment Treatment

Medical Medical Surgical Surgical

Proptosis Proptosis

Protrution:Protrution:

of the eyes secondary to and orbital of the eyes secondary to and orbital space lesion space lesion

Exophthalmos:Exophthalmos:

proptosis secondary to dysthyroid proptosis secondary to dysthyroid disease.disease.

EvaluationEvaluation

History of proptosis History of proptosis Slow Slow AbruptAbrupt Explosive Explosive DisplacementDisplacement AxialAxial Medial Medial LateralLateral

EvaluationEvaluation

DiplopiaDiplopia

HorizontalHorizontal

VerticalVertical PainPain

ReferredReferred

OcularOcular

EvaluationEvaluation

Vision (Decrease)Vision (Decrease)

Slowly Progressive Slowly Progressive

Not effected Not effected

BBLOW OUT LOW OUT FRACTUREFRACTUREEEVALUATION AND VALUATION AND TREATMENTTREATMENT