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The orbit by Mind Map: The orbit

1. *investigation: -thyroid function tests; - anti thyroid antibodies. -Orbital CT & MRI.

2. *symptoms: -painful, proptosed eye; - conjunctival injection; - periorbital inflammation and swelling; - reduced eye movements; -possible visual loss; - systemic illness and pyrexia.

3. ##CAUSES OF PROPTOSIS : A. BILATERAL PROPTOSIS 1. Endocrine exophthalmos due to dysthyroid eye disease. 2. Cavernous sinus thrombosis. 3. Metastatic neuroblastoma. 4. Orbital myositis (due to causes other than thyroid dysfunction). B.UNILATERAL PROPTOSI : 1. Haemangioma.- 2. Dermoid 3. Lymphangioma. 4. Rhabdomyosarcoma. C. -TRANSIENT PROPTOSIS 1. Arterio-venous malformations. 2. Orbital varices.

4. ORBITAL CELLULITIS

4.1. *Inflammation and infection of the orbital soft tissues posterior to the orbital septum.

4.2. *complications: -Brain abscess -Cavernous sinus thrombosis -Meningitis - blindness

4.3. *diagnosis: • 1. Mainly by clinical evaluation • 2. MRI (CST) • 3. CT Scan

4.4. *Treatment: • Admission & Broad spectrum IV antibiotics. • draining the abscess • Orbital decompression

5. # Disorders of the extra ocular muscles : - Dysthyroid eye disease. - Ocular myositis.

5.1. Dysthyroid Eye Disease

5.1.1. * symptoms: - red painful eye. -double vision. -reduced visual acuity.

5.1.2. *Autoimmune disorder with orbital involvement frequently associated with thyroid dysfunction. *90% occurs in smokers.

5.1.3. *Sign : - proptosis. -chemosed. -The upper lid may be retracted. -The upper lid may lag. - restricted eye movements.

5.1.4. *Complications: - corneal ulcers. -corneal perforation. -blindness

5.2. *Management: -Emergency >> systemic steroids -The long term >> The first step is the regulation of thyroid hormones levels-Artificial tears-Glasses-Stop smoking.

5.3. Ocular myositis

5.3.1. *This is an inflammation of the extraocular muscles

5.3.2. *symptoms - pain. -diplopia. - restriction in the movement of the involved muscle.

5.3.3. *investigation: -CT or MRI.

5.3.4. *treatment: -steroids.

6. # Inflammatory disorder: - sarcoidosis. -orbital pseudotumor0 -non -specific lymphofibro_blastic disorder.

7. # Infective disorder: - Orbital cellulitis. - Preseptal cellulitis.

7.1. PERIORBITAL CELLULITIS

7.1.1. * Involves the tissues anterior to the orbital septum

7.1.2. *Complications: 1. Orbital abscess 2. Orbital mucocele

7.2. *Relative recession (backward or downward displacement) of the globe into the bony orbit.

8. Dermoid Cysts

8.1. *symptoms: -painless mass. -may be skin-colored or slight yellow tinged.

8.2. *overgrowth of ectodermal tissue beneath the surface.

8.3. *treatment: -surgery to remove the cyst

9. TRAUMA

10. # Orbital tumors: -lacrimal gland tumours -optic nerve gliomas - meningiomas -lymphomas -rhabdomyo_sarcomas -metastasis

10.1. Secondary (mets)

10.1.1. • metastasis from other systemic cancers ; • (neuroblastomas in children) • (the breast 40%, lung, prostate or gastrointestinal tract in adults).

11. # Vascular abnormalities: - carotid cavernous fistula - Orbital varices(varix) - Capillary hemangioma

11.1. Capillary Hemangiomas

11.1.1. *They are benign endothelial cell neoplasms that lead to vessle growth stimulation.

11.1.2. *symptoms: - red Swelling of the upper lid - may cause sufficient ptosis - cause amblyopia.

11.1.3. *Treatment: - local injections of steroids. - Incisional surgical

12. Endophthalmos

13. Enophthalmos

13.1. *sunken appearance

13.2. *causes: 1- Primary (congenital) -inadequate, orbital cavity development). 2-Secondary(acquired) -Blow out trauma -Horner’s Syndrome -Postsurgical muscle shortening

13.3. *treatment : - reconstruction of the bony orbit and repositioning of the globe