ORBIT PROPTOSIS BY PROF DR WASEEM AHMED KHAN

ORBIT & PROPTOSIS BY PROF DR. WASEEM AHMED KHAN MBBS, DOMS, MCPS, FRCS

OBJECTIVES OF THE LECTURE BY END OF THIS LECTURE, STUDENTS SHOULD BE ABLE 1. Understand the Clinical anatomy of the Orbit 2. Enlist the causes of the Proptosis 3. Discuss the common diseases of the Orbit

ORBIT

ORBIT • Orbit is the Pear Shaped cavity, the stalk of which is the optic canal. • Roof consist of Two bones: lesser wing of the sphenoid bone and orbital plate of frontal bone. • Lateral wall also consist of two bones: the greater wing of sphenoid bone and the zygomatic bone.

ORBIT • Floor consist of zygomatic bone, maxillary bone and palatine bone. • Medial wall consists of four bones: Maxillary, lacrimal, ethmoid and sphenoid bone.

PROPTOSIS : is the abnormal protrusion of an organ; exophthalmos refers specifically to the eye ball only

PROPTOSIS Ø Definition Ø Exophthalmos Ø Etiology (VEIN) Infection Inflammation Neoplasm Vascular Endocrine Ø Clinical feature Ø Investigations Ø Treatment

PRESEPTAL CELLULITIS

PRESEPTAL CELLULITIS Definition Acute infection of periocular tissues anterior to orbital septum Etiology trauma, extension of infection Clinical features Eyelid: oedematous , tender Erythema: purple red. Sharply demarcated swelling Treatment: Oral antibiotics, some times intravenous antibiotics

ORBITAL CELLULITIS Ø It is the acute infection of the orbital soft tissues posterior to orbital septum. Ø Etiology Extension of infection Endogenous infection Post traumatic Post surgical Endophthalmitis

CLINICAL FEATURES OF ORBITAL CELLULITIS Symptoms: Rapid onset of orbital swelling and pain along with fever and malaise Signs: Axial proptosis Periorbital and lid oedema Skin red warm tender EOM are restricted, painful Decreased vision

Investigations § Blood CP, ESR, Blood culture. Orbital ultrasonography § CT Scan orbit, sinuses, brain Complications § Orbital abscess, Cranial nerve palsies. Cavernous sinus thrombosis § Blindness. Meningitis. Brain abscess § Death Treatment § Medical: sys. Antibiotics, NSAIDs § Surgical