Term
| What are classic signs of orbital disease? |
|
Definition
-lid and periorbital edema
-chemosis and conjunctival injection |
|
|
Term
| What are classic causes of orbital disease? |
|
Definition
-thyroid eye disease
-orbital cellulitis
-inflammatory disease
-A-V shunts |
|
|
Term
| Proptosis is usually what kind of lesion? |
|
Definition
|
|
Term
| Lesions within the muscle cone cause what kind of proptosis? |
|
Definition
|
|
Term
|
Definition
| -lateral or vertical displacement of globe |
|
|
Term
dystopia is usually due to what? |
|
Definition
| -extraconal mass such as a lacrimal gland tumor |
|
|
Term
|
Definition
|
|
Term
|
Definition
| -defective ocular motility |
|
|
Term
| What are causes of ophthalmoplegia? |
|
Definition
-orbital mass
-thyroid disease
-motor nerve lesions
-tethering of muscles in fracture |
|
|
Term
| What test is used to differentiate between restrictive and neurological ophthalmoplegia? |
|
Definition
|
|
Term
| What are some causes of visual dysfunction in Orbital disease? |
|
Definition
-exposure keratopathy
-compression of optic nerve
-choroidal folds |
|
|
Term
| What are dynamic properties of orbital disease? |
|
Definition
| -features that may give clues to probable pathology |
|
|
Term
| List three possible dynamic properties of orbital disease. |
|
Definition
-bruit
-pulsations
-increased venous pressure |
|
|
Term
| What are classic fundus signs seen in orbital disease? |
|
Definition
-choroidal folds
-disc edema and optic atrophy
-vessel occlusions, shunts, dilation or tortuosity |
|
|
Term
| What would you check upon evaluation for orbital disease? |
|
Definition
-ocular displacement
-palpation
-bruit
-eye motility
-funduscopy
-biomicroscopy
-CTscan, xray
-T3, T4, TSH |
|
|
Term
| What does the water view refer to? |
|
Definition
| -x-ray taken with a tilted back head position to check for orbital floor fractures |
|
|
Term
| Why is a CT scan useful in orbital disease Dx? |
|
Definition
| - because of differences in density between orbital fat and structures |
|
|
Term
| What kind of exam would you order for orbital trauma examination? |
|
Definition
|
|
Term
What type of MRI would you choose for pathological examination?
|
|
Definition
| T2 weighted (vitreous bright and fat dark) |
|
|
Term
| What are some conditions/features that lead to sever pain in orbital disease? |
|
Definition
-idiopathic orbital inflammatory disease
-hemorrhage, cellulitis
-posterior scleritis
-lacrimal gland tumours |
|
|
Term
| What signs would appear to progress rapidly in orbital disease? |
|
Definition
-orbital cellulitis
-IOID
-hemorrhage
-rhabdosarcoma |
|
|
Term
| What signs would appear to progress slowly in OD? |
|
Definition
-thyroid opthalmopathy
-dermoid cyst
-cavernous hemangioma
-tumours |
|
|
Term
| What might a pulsation with bruit suggest? |
|
Definition
-A/V malformation
-carotico-cavernous fistula |
|
|
Term
| What is the most common cause of axial proptosis? |
|
Definition
|
|
Term
| What are the main feature of Thyroid eye disease? |
|
Definition
|
|
Term
| What are secondary finding in Thyroid eye disease? |
|
Definition
-lid retraction
-corneal exposure
-SLK
-diplopia
-ON involvement |
|
|
Term
| What are the feature of pathogenesis of thyroid eye disease? |
|
Definition
-EOM growth (up to 8x)
-may compress ON
-muscle fibrosis (restrict movement)
-inflammatory cell infiltration
-may elevate IOP |
|
|
Term
| What is the pathology of EOM inflammation in Thyroid eye disease? |
|
Definition
-hypertrophic EOM due to accumulation of glycosaminoglycans
-lymphocytic infiltration |
|
|
Term
| What are some visual signs of thyroid eye disease? |
|
Definition
-decreased acuity
-CV defect
-RAPD
-ON atrophy
-visual field changes |
|
|
Term
| How would you manage soft tissue involvement in thyroid eye disease? |
|
Definition
-lubricants
-head elevation
-taping lids closed at night |
|
|
Term
| What is the pathogenesis of lid retraction? |
|
Definition
-fibrotic contracture of levator
-overaction of levator-superior rectus in response to fibrosis of inferior rectus
-over action of muller muscle |
|
|
Term
| What is the dalrymple and von graefe sign associated with? |
|
Definition
|
|
Term
| What are two pathologies of proptosis? |
|
Definition
-exposure keratopathy
-corneal ulceration |
|
|
Term
| What are the features of Optic Neuropathy due to thyroid eye disease? |
|
Definition
-impaired central vision
-reduce VA
-RAPD
-VF defects
-optic disc may be normal, swollen or atrophic |
|
|
Term
| What is restrictive myopathy and what causes it? |
|
Definition
-ophthalmoplegia due to TED
-due inflammatory edema and later by fibrosis |
|
|
Term
What is the most common motility defect in restrictive myopathy?
|
|
Definition
|
|
Term
| What are possible causes of orbital cellulitis? |
|
Definition
| -Bacterial infection due to sinusitis, trauma, Sx, dacryocystitis |
|
|
Term
| What are the classic signs/sxs of orbital cellulitis? |
|
Definition
-fever, malaise
-reduced vision (ON involvment)
-proptosis
-opthalmoplegia |
|
|
Term
| What is another name of orbital pseudo tumour? |
|
Definition
|
|
Term
|
Definition
| -portion of skull contents herniates into orbit through defect in orbital wall |
|
|
Term
| You notice a Px with exopthalamos. Upon percussion of orbit you hear no bruit. Blood test indicate possible tumor. What might be Dx? |
|
Definition
|
|
Term
| What is a carotid cavernous fistula? |
|
Definition
-arteriovenous communication between carotid artery and cavernous sinus
- |
|
|
Term
| What is ocular pathology of cavernous sinus fistula? |
|
Definition
-venous/arterial stasis around eye
-increased episcleral venous pressure
-decrease in arterial blood flow to the cranial nerves |
|
|
Term
| what are causes for EOM restriction? |
|
Definition
-myopathy (TED)
-trapped inferior rectus (blow out)
-orbital mass
-ocular motor nerve lesions |
|
|
Term
| Name two orbital tumours. |
|
Definition
-rhabdosarcoma
-orbital dermoid cyst |
|
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