By John Bryan Holds MD

Information the anatomy of the orbit and adnexa, and emphasizes a pragmatic method of the review and administration of orbital and eyelid problems, together with malpositions and involutional adjustments. Updates present info on congenital, inflammatory, infectious, neoplastic and anxious stipulations of the orbit and accent buildings. Covers key points of orbital, eyelid and facial surgical procedure. comprises quite a few new colour photographs. significant revision 2011-2012.

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Additional info for 2011-2012 Basic and Clinical Science Course, Section 7: Orbit, Eyelids, and Lacrimal System (Basic & Clinical Science Course)

Sample text

Thalmology Mo nograph 9. San Francisco: American AcademyofOph lhalmology; 1996. CHAPTER 2 Evaluation of Orbital Disorders The evaluation of an orbital disorder should distinguish orbital from periorbital and in traocu lar lesions. This distinction provides a framework for development of a differential diagnosis. The evaluation begins with a detailed history to establish a probable diagnosis and gu ide the initial workup and therapy. Such a history should include • onset, course, and duration of symptoms (pain, altered sensation, diplopia, changes in vision) and signs (e rythema, palpable mass, globe displacement) prior d isease (s uch as thyroid eye disease [TED] or sinus disease) and therapy injury (especiall y head or facial trauma) systemic disease (es pecially cancer) fam ily hi story Old photographs are frequen tl y helpful for evaluating onset of globe displacement and estab lishing duration of the disease.

The eyelid crease approach to slipe rficiallateral dermoid cysts. ls. 1988;25( 1) :48-51. Shields JA, Kaden IH , Eagle RC Jr, Shields CL. Orbital dermoid cysts: clinicopathologic correlations, classification, and management . Ophtha! lrg. 1997;13(4 ):265 - 276. Dermolipomas Dermo lipo mas are solid tU lllo rs usuall y located beneath the conjun ctiva over the globe's lateral surface (Fig 3-4) . These benign lesio ns m ay have deep extensions that can extend to the levato r an d extraocular muscles.

Althoug h nasal deco ngestants may help to promote spontaneous drain age of the infected si nus, ea rly surgical intervent ion to drain the invo lved sinus is u su ally indicated, especiall y if orbital findings progress during IV antibiotic th e rapy. In cont rast, orbital cell u litis in children is more often caused by a single gram - positive orga nism and is less likely to req ui re surgical drainage of the infected sinus. Orbi tal cellulitis foll owi ng blowout fract ures is gene rall y limited to pat ients with un derl ying sinus d isease.

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