Ординатура / Офтальмология / Английские материалы / Illustrated Tutorials in Ophthalmology Kanski, Bolton 2001
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Associations of encephaloceles
Ocular |
Other congenital bony Neurofibromatosis - 1 |
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defects |
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Colobomas |
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Hypertelorism |
• Common in posterior |
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encephalocele |
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Morning glory anomaly |
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Hare lip and cleft palate |
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ORBITAL TUMOURS
1.Vascular tumours
•Capillary haemangioma
•Cavernous haemangioma
2.Lacrimal gland tumours
•Pleomorphic adenoma
•Carcinoma
3.Neural tumours
•Optic nerve glioma
•Optic nerve sheath meningioma
•Sphenoidal ridge meningioma
4.Miscellaneous tumours
•Lymphoma
•Rhabdomyosarcoma
•Metastases
•Invasion from sinuses
Capillary haemangioma
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Natural history |
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Systemic associations |
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High output cardiac failure |
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Kasabach-Merritt syndrome - |
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thrombocytopenia, anaemia |
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Maffuci syndrome - skin |
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haemangiomas, enchondromata |
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Treatment |
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Steroid injections - for superficial |
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component |
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Systemic steroids |
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Local resection - difficult |
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Growth during first year |
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Subsequent resolution - |
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complete in 70% by age 7 years |
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Cavernous haemangioma
•Most common benign orbital tumour in adults
•Usually located just behind globe
•Female preponderance - 70%
•Presents - 4th to 5th decade
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Slowly progressive axial proptosis |
May cause choroidal folds |
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Treatment - surgical excision
Classification of lacrimal gland tumours
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Pleomorphic Lacrimal Gland Adenoma
Presents - 4th to 5th decade
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Painless and very slow- |
• Posterior extension may |
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Smooth, encapsulated |
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growing, smooth mass in |
cause proptosis and |
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outline |
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lacrimal fossa |
ophthalmoplegia |
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Excavation of lacrimal gland |
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Inferonasal globe |
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fossa without destruction |
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displacement |
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Lacrimal gland carcinoma
•Presents - 4th to 6th decades
•Very poor prognosis
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Painful, fast-growing mass in |
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Posterior extension may cause proptosis, |
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lacrimal fossa |
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ophthalmoplegia and episcleral congestion |
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Infero-nasal globe displacement |
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Trigeminal hypoaesthesia in 25% |
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Management
•Biopsy
•Radical surgery and radiotherapy
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