Orbital Infections And Inflammations

Question 1

ORBITAL INFECTIONS AND
INFLAMMATIONS

Answer 1

1. Orbital cellulitis
   2.Idiopathic orbital inflammatory disease
   (IOID)
2. Dacryoadenitis
3. Orbital myositis

Question 2

The most common cause of proptosis in children

Answer 2

ORBITAL CELLULITIS

Question 3

Most cases occur in children, but can be present in the aged and immunocompromised individuals

Answer 3

ORBITAL CELLULITIS

Question 4

Most cases arise from extension of sinusitis through the ethmoid bones

Answer 4

ORBITAL CELLULITIS

Question 5

Organisms commonly found in sinusitis: Haemophilus Influenza, Streptococci and staphylococci

Answer 5

ORBITAL CELLULITIS

Question 6

Infection behind orbital septum

Answer 6

ORBITAL CELLULITIS

Question 7

Usually secondary to ethmoiditis

Answer 7

ORBITAL CELLULITIS

Question 8

Presentation of ORBITAL CELLULITIS

Answer 8

Severe malaise, fever and orbital signs

Question 9

Signs of ORBITAL CELLULITIS

Answer 9

Severe eyelid oedema and redness
Proptosis- most frequently lateral and down
Painful ophathalmoplegia
Optic nerve dysfunction if advanced

Question 10

Complications of ORBITAL CELLULITIS

Answer 10

Rajsed intraocular pressure
Retinal vasculature occlusion
Optic neuropathy

Question 11

the formation of blood clot within the cavernous sinus, (a cavity at the base of the brain which drains deoxygenated blood from the brain back to the heart)

Answer 11

Cavernous sinus thrombosis

Question 12

from a spreading infection in the nose, sinuses, ears, eyes or teeth

Answer 12

Cavernous sinus thrombosis

Question 13

dec. or loss of vision
– chemosis
–exophthalmos
– HA & paralysis of the cranial nerves

Answer 13

Symptoms of Cavernous sinus thrombosis

Question 14

Symptoms of Cavernous sinus thrombosis

Answer 14

dec. or loss of vision
– chemosis
–exophthalmos
– HA & paralysis of the cranial nerves

Question 15

Pre-treatment of orbital cellulitis

Answer 15

Hospital admission
Systemic antibiotic therapy
Monitoring optic nerve function

Question 16

Post-treatment of orbital cellulitis

Answer 16

Indications for surgery
1. Resistance to antibodies
2. Orbital or subperiosteal abscess
3. Optic neuropathy

Question 17

ORBITAL PSEUDOTUMOR

Answer 17

IDIOPATHIC ORBITAL INFLAMMATORY DISEASE

Question 18

Uncommon disorder characterized by non-neoplastic & non-infectious, space occupying, orbital lesions

Answer 18

IDIOPATHIC ORBITAL INFLAMMATORY DISEASE

Question 19

Presence of inflammatory process in any or all orbital structures

Answer 19

IDIOPATHIC ORBITAL INFLAMMATORY DISEASE

Question 20

Unilateral disease is the rule in adults

Answer 20

IDIOPATHIC ORBITAL INFLAMMATORY DISEASE

Question 21

Non-neoplastic, non-infectious orbital lesion (pseudotumour)
• Involves any or all soft-tissue components
• Presentation - 20 to 50 years with abrupt painful onset

Answer 21

Idiopathic orbital inflammatory disease

Question 22

Usually unilateral
Preorbital swelling and chemosis, conjunctival inflammation
Proptosis
Ophthalmoplegia

Answer 22

Idiopathic orbital inflammatory disease

Question 23

Early spontaneous remission without sequelae

Answer 23

Nil

Question 24

Prolonged intermittent activity with eventual remission

Answer 24

Treatment- steroids, radiotherapy, or cytotoxics

Question 25

refers to inflammation of the lacrimal gland and may be unilateral or bilateral

Answer 25

DACRYOADENITIS

Question 26

Occurs in 25% of patients with IOID • Usually affects otherwise healthy individuals - no treatment required

Answer 26

Dacryoadenitis

Question 27

Presentation of dacryoadenitis

Answer 27

Acute discomfort over lacrimal gland

Question 28

Signs of dacryoadenitis

Answer 28

Oedema of lateral aspect of upper lid Mild downward and inward globe displacement Injection and tenderness of palp lobe of lacrimal gland Reduction in tear secretion

Question 29

Inflammatory enlargement of lacrimal gland Rapid onset Unilateral severe pain redness and pressure Supratemporal region

Answer 29

Dacryoadenitis

Question 30

Infectious obstruction or nasolacrimal duct Rapid onset Unilateral severe pain redness and epiphora (overflow of tears) Inframedial region

Answer 30

Dacryocystitis

Question 31

Subtype of IOID • Involvement of one or more extraocular muscles

Answer 31

Orbital myositis

Question 32

• Presentation of orbital myositis

Answer 32

sudden onset of pain on ocular movement

Question 33

Underaction of left lateral rectus Worsening of pain on attempted left gaze CT shows fusiform enlargement of left lateral rectus

Answer 33

Orbital myositis

Question 34

Signs of orbital cellulitis

Answer 34

Severe eyelid oedema and redness Proptosis- lateral and down Painful ophthalmoplegia optic nerve dysfunction if advanced

Question 35

Most cases arise from extension of sinusitis through

Answer 35

Ethmoid bone

Question 36

Cause of cavernous sinus thrombosis

Answer 36

Spreading infection in the nose sinuses ears eyes or teeth

Question 37

Symptoms of cavernous sinus thrombosis

Answer 37

Decrease or loss of vision Chemosis Exophthalmos Abnormality of the cranial nerve

Question 38

Signs of idiopathic orbital inflammatory disease

Answer 38

Unilateral Periorbital swelling and chemosis, conjunctival inflammation Proptosis Ophthalmoplegia

Question 39

Organisms found in sinusitis

Answer 39

Haemophilus Influenza, Streptococci and staphylococci