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40 Cards in this Set
- Front
- Back
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Common causes of preseptal cellulitis
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Hordeolum (#1), dacrocystitis, skin trauma(insect bite)
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Orbital cellulits
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-common cause of exophthalmos in kids
-hx of fever, *sinus(ethmoid)/dental infection, trauma -Staph (adults), influenza(flu) (kids) -Immunocompromised can develop mucormycosis(fungus) leads to black eschar (mouth, nose) |
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Ddx orbital from preceptal
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Preceptal:no fever, proptosis, EOM restriction, increased pain with eye-movement
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Normal exophthalmometry readings:
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Whites:12-22
Blacks:12-24 Asians:12-18 Assymetry <4mm |
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thyroid eye disease (TED)
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"NO SPECS"
-Kocher's sign (the stare) -Von Graefe's sign(lid lag during downgaze) -Corneal exposure (SPK,SLK) -Inferior rectus first -Inflammation at orbital apex>nerve damage |
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Carotid Cavernous Fistula
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-Abnormal communication between artery and vein.
-Increases venus BP resulting in decreased outflow from orbit>**Pulsatile proptosis, redness, chemosis, CN6 palsy, bruit |
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Cavernous Hemangioma
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**Most common benign orbital tumor in adults
-Unilateral proptosis (tumor post. to globe) |
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General symptoms of Orbital Tumors
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APD, progressive decrease in VA, progressive proptosis (unilaterl)
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Capillary Hemangioma
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**Most common benign orbital tumor in children (capillaries are small, kids are small)
-Usually diagnosed early because of strawberry cutaneus lesions -70% are gone by age 7 |
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Rhabdomyosarcoma
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"RhaBD-rapid bone descruction"
-**Most common malignant pediatric orbital tumor -Tumor of mesenchyme (bone) |
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Neuroblastoma
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**2nd most common overall malignant tumor in peds (after Rhabdo)
**Most common secondary pediatric tumor -Usually kid already has abdomen cancer |
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Meningioma
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**Most common benign brain tumor
-Middle aged women -Slow vision loss, proptosis nerve swelling, APD, diplopia |
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Most common intercranial tumor to spread to orbit
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Sphenoid meningioma
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Primary orbital meningiomas classic triad:
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VA loss, optic atrophy, optociliary shunt vessels (connect choriod with retina)
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Dermoid Cysts
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Contain hair follicles and sebaceous glands
-GOLDENHAR's syndrom (ocular dermoid, skin tag, vertebral dysplasia) |
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Lymphoma
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Slow onset tumor of orbit
50-70yo |
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optic nerve glioma (juvenile pilocytic astrocytoma)
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-age 2-6
*Most common intrinsic tumor of optic nerve -50%association with neurofibromatosis type 1 (lisch nodules, fibromas, cafe aulait spots) |
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Orbital pseudotumor
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Similar to thyroid eye disease (20-50, unilateral, proptosis) but also has sudden pain and inflammation of periorbit (chemosis, lacrimal, hyperoptic shift)
-Idiopathic inflammator process -If bilateral, Raise suspicion for Wegeners granulomatosis, Polyarteritis nodosa, lymphoma |
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Tolosa-Hunt Syndrome
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Inflammation of Cavernous sinus (CN 3,4,5i,5ii,6) resulting in possible paresis of these nerves
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Ocular rosacea
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-Common, middle aged women of european ancestry
-Telangetasia, rhinophyma(huge nose) -**Triggers (food, sun) |
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Ocular cicatridcial Pemphigoid
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-Autoimmune damge to mucus membranes
-Symblepharon (eyelid-eyeball) -Ankyloblepharon(eyelid-eyelid -can be drug induced (beta blocker) |
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Dermatochalasis
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Weakend orbital septum allows prolapse of fat
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Chalazion
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-sterile inflammation
-ask about acne rosacea, seborrheic dermatitis |
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Hordeolum
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Acute staph infection of meibomian glands(internal), zeis/moll (external)
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Ectropion
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-out turning of lid
-mechanical (tumor -cicatricial -paralytic -congenital -involutional(age related) |
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Entropion
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-can cause keratitis to pannus
-can be caused by Tracoma -classically cause by lashes growing posteriorly of Distichiasis (second row of lashes from meib glands) |
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Floppy eyelid Syndrome
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**Obese men with sleep apnea
-Spontaneos upper lid eversion and pillow exposure |
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Benign Essential Blepharospasm
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*Bilateral
-spasms of Obicularis, procerus, corrugator -often accompanied by DES -if also suffers lower face abnormalities>Meige's syndrome |
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Basal Cell Carcinoma
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-More common in males 2:1
-**Most common eyelid cancer (90%) -Small firm shiny pearl with "rodent ulcer(late sign)" -lower lid, UV exposure -Surface telangetasia |
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Squamous cell carcinoma
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-2nd most common eyelid cancer
-erythematous Plaque -Often derived from actinic keratosis |
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Actinic Keratosis
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-Premalignant elevated pink scaly lesion on sus-exposed skin
-*MOST common pre-malignant skin lesion) |
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Sebaceous Gland Carcinoma
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*Bad boy of lid
**Recurrent chalazion *unilateral bleph -madarosis, lymphadenopathy -Arises from meibmian glands |
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Malignant Melanoma
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Extreamly rare but are most lethal primary skin cancer
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Keratocanthoma
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Initially similar to BCC or SCC, then they grow quickly, then involute/resolve.
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Common causes of nasolacrimal duct obstruction
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Involutional Stenosis (older people) Membranous blockage of valve of Hasner (youner)
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dacrycystitis
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-occors shen duct is plugged,
-Always below medial canthal tendon -if above could indicate tumor -If chronic, suspect cancer *don't irrigate/refer untill tx started |
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canaliculitis
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-unresponsive to AB tx
-Pouting puncta -Discharge with palpation *Most common cause Israeli bacteria |
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Dacroadenitis
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*S-shaped ptosis
-Most common is chronic(*sarcoid, TB, graves) -Rule out tumor with biopsy -Acute: bacteria, virus, fever |
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Jones 1 test
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Fluorescein is instilled, after 5 min eye is examined for NaFl, if it's gone and patient has NaFl in throat/nose that equals (+)test. Positive for flow.
-If (-) perform Jones 2 |
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Jones 2 test
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Irrigate, if saline comes out either punctum it's blocked
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