Orbit

Carotid-Cavernous Fistula SYMPTOMS Orbital pain/pressure | diplopia | swishing sound | headaches | rarely vision loss SIGNS Pulsatile proptosis | Horner’s syndrome | EOM restrictions | dilated (corkscrew) conjunctival and episcleral vessels | chemosis | elevated IOP | tortuous retinal veins | vein occlusions | papilledema | retinal hemorrhages DIRECT carotid-cavernous fistulas (usually high flow…

Arteriovenous Malformation SYMPTOMS Headaches | seizures | mental impairment | reduced vision due to retinal ischemic events | orbital pain | orbital pressure | diplopia | ocular redness SIGNS Pulsatile proptosis | EOM restriction | Dilated conjunctival and episcleral vessels in a corkscrew configuration | Conjunctival chemosis | Elevated IOP | Tortuous retinal veins |…

Grave’s Disease (Thyroid Related Ophthalmopathy) SYMPTOMS Foreign body sensation, diplopia, reduced vision SIGNS Upper eyelid retraction (w/lateral flare), upper lid lag on downgaze (pseudo-von Graefe sign), proptosis, lagophthalmos, periorbital/lid swelling, EOM restriction, exposure keratopathy, optic nerve swelling due to compression Progression/Severity of Grave’s Disease (NOSPECS) N: No symptoms or signs O: Signs but no symptoms…

Orbital Cellulitis SYMPTOMS Eye pain/tenderness, blurry vision, headache/pressure, fever, tooth pain SIGNS Red and swollen eyelid, EOM restriction, proptosis, pain on eye movement, possible APD if there is optic nerve involvement WORK-UP Thorough history: Ask about trauma, surgery, sinus/systemic/tooth infection, immunosuppression, and neck stiffness. Thorough ocular examination: Check for EOM restrictions, proptosis, IOP, optic nerve…