ORBITAL DISEASES

Bones Of the orbit

Types Of Orbital Diseases :• Inflammations :1-Orbital cellulitis2-Cavernous Thrombosis• Endocrine Diseases :1-Thyrotoxicosis2-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

Myxoedema Orbital celluitis

Carotico-cavernous fistula Orbital 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