Orbital inflammation

Question 1

What is ophthalmoplegia?

What is the diagnostic test?

Answer 1

Restrictions ocular movement due to orbital mass, lesion in the cavernous sinus, orbital fissures or posterior orbit

Forced duction test: local anaesthetic and foceps are used to force movement. Resistance = ophthalmoplegia

Question 2

Clinical finding of optic disc swelling. What should you consider?

Answer 2

Possibly cause by compressive optic neuropathy

Question 3

Clinical finding of Optic Atrophy: possible causes

Answer 3

Glaucoma
Severe compressive optic neuropathy
Thyroid eye disease
Optic nerve tumour

Question 4

What auxiliary test should be considered in orbital inflammation?

Answer 4

CT (for bony or space occupying lesion)
MRI brain and orbit (for soft masses)
Biopsy (esp if neoplastic cause is suspected)

Question 5

Clinical finding of proptosis. List possible causes

Name the tool used to measure it

Answer 5

Thyroid eye disease (graves)
Cavernous haemangiona
tumour (lacrimal or optic nerve)

Exophthalmometer