ORBITAL DISEASES

Bones Of the orbit

Types Of Orbital Diseases : Inflammations : 1-Orbital cellulitis 2-Cavernous Thrombosis Endocrine Diseases : 1-Thyrotoxicosis 2-Myxoedema Neoplasms : 1- Malignant 2-Benign

Orbital Cellulitis It is purulent inflammation of cellular tissues of the orbit(serious)due to:Infection-neighbouring parts(sinuses teeth face- lips-penetrating injury septic operation panophthalmitis – metastasis from septicemia Symptoms: sever pain e movement z eye- chemosis –diplopia Signs: lid swelling conj proptpsis impaired mobility diplopia Vision is not affected fever fundus normal Complications: Abscess panophthalmitis meningitis optic atrophy Cavernous thrombosis death. Ttt:Hot compress antibotics analgesia drainage of abscess

Cavernous Thrombosis From sources which communicate with c sinus Symptoms as o cellulitis(sever) Signs Oedema of mastoid bone to be bilatral paralysis of muscles Fundus:Retinal veins dilated engorged papilitis papilloedema Complications menengitis cerebral abscess death Ttt:masive ttt anticoagulant

Examining for exophtalmos Examination for displacement of the eye

Endocrine Exophthalmos Types:thyrotoxicosis Hypothyroidism Thyrotropic exophthalmos Signs:General Ocular Ttt:Anti thyroid drugs corticosteroids

Thyrotoxicosis with exophthalmos eyelid retraction and defective eye movement

MyxoedemaOrbital celluitis

Carotico-cavernous fistulaOrbital tumor

Blinding Diseases Trachoma Onchocerciasis Vit A Trachoma: chlamydia trachomatis WHO classifications 1- TF (follicles > 5 ) 2- T1 marked inflammations Intense :thickening of tarsus--- obscures of vessels 3- TS (scarring) tarsal conj, pannus(limbus) 4- TT (trachomatous trichiasis ) rubing lashes- entropion 5- CO (corneal opacity) results visual impairment

Diagnosis: 1- follicles or papillae 2- Epithelial keratitis 3- Pannus 4- Typical star –shape scarring of conj Lab: Ttt 1- Topical – Tetracycline ointment 2- systemic 3- surgical ttt for complications

Vit A deficiency Night blindness Conj xerosis – bitot’s spot Cornel xerosis / Keratomalacia Xerophthalmic fundus Ttt - vit A (WHO) (200,000 IU ) – childern dose (50,000 IU/kg ) - next day (200,000 IU ) - after a week (200,000 IU ) Sources of vit A : Vegetables – liver – egg yolk …etc

ONCHOCERCIASIS river blindness cause by nematode worm (onchocerca volvulus )- blindness Disease transmission : nematodes adult worms (2-3 female worms twisted ---- millions of microfilariae ) Vector (blackfly – genus Simulium ) Ocular Manifestations: - live MFS in A/C - keratitis - uveitis –chorio-retinitis – optic atrophy – optic neuritis-Night blindness – Visual field loss – Irreversible blindness Genral :Pruritus – subcutaneous nodules – psychological & sleep disorders – lymphadenopathy – hyposexual dwarfism – epilepsy Control : Vector control (chemotherapy with ivermectin ) Blackfly irradications