Ординатура / Офтальмология / Английские материалы / Ocular Differential Diagnosis 7th edition_Roy_2002
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Ophthalmology 2000;107:2215â??2219.Bibliographic Links
Nicholson DH, Green WR, eds. Pediatric ocular tumors. New York: Masson, 1981.
Steinkuller PG, Font RL. Congenital malignant teratoid neoplasm of the eye and orbit. Ophthalmology 1997;104:38â??42.Bibliographic Links
Tornerup NR, et al. HV-1 induced acute retinal necrosis syndrome presenting with severe inflammatory orbitopathy proptosis and optic nerve involvement. Ophthalmology 2000;107:397â??401.Bibliographic Links
Wright JE, et al. Orbital venous anomalies. Ophthalmology 1997;104:905â??913.Bibliographic Links
Diagnostic tables
Exophthalmos (up to 1 year)
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Exophthalmos (1â??5 years)
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Exophthalmos (5â??10 years)
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Exophthalmos (10â??30 years)
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Exophthalmos (30â??50 years)
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Exophthalmos (50â??70 years)
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Exophthalmos (more than 70 years)
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Pulsating exophthalmos (most common)
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Recurrent exophthalmos
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Enophthalmos
1. Senility (common)
2. Wasting diseasesâ??loss of orbital fat
3. *Injuryâ??blowout fracture of floor of orbit (most common) 4. Orbital varicesâ??transient exophthalmos with fat atrophy
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5. Chronic or severe liver or gallbladder disease (usually in right eye owing to increased tone of orbicularis muscle and extraocular muscles)
6. Iatrogenic
A.Orbital decompression
B.Sinus surgery
7. Superior sulcus deformity
A.Traumatic bony loss
B.Atrophy of the orbital tissues
C.Levator detachment with ptosis
D.Migration of muscle cone implant
E.Herniated orbital fat secondary to an orbital fracture
8. Associated syndromes
A.Arthrogryposis (amyoplasia congenital)
B.Babinskiâ??Nageotte syndrome (medullary tegmental paralysis)
C.Cestanâ??Chenais syndrome (lesion in the lateral portion of medulla oblongata)
D.Cockayne syndrome (dwarfism with retinal atrophy and deafness)
E.Craniocervical syndrome (whiplash injury)
F.Cretinism (hypothyroidism)
G.Cryptophthalmia syndrome
H.Dejean syndrome (orbital floor syndrome)
I.Dejerineâ??Klumpke syndrome (thalamic hyperesthetic anesthesia)
J.Duane retraction syndrome
K.Freemanâ??Sheldon syndrome (craniocarpotarsal dysplasia)
L.General fibrosis syndrome
M.Greig syndrome (ocular hypertelorism syndrome)
N.Hemifacial microsomia syndrome (Françoisâ??Haustrate syndrome)
O.Horner syndrome (cervical sympathetic paralysis syndrome)
P.Klippelâ??Trenaunayâ??Weber syndrome (angioosteohypertrophy syndrome)
Q.Krause syndrome (encephaloophthalmic syndrome)
R.Maple syrup urine disease (branched chain ketoaciduria)
S.Morquio syndrome (MPS IV)
T.Naffziger syndrome (scalenus anticus syndrome)
U.Pancoast syndrome (superior pulmonary sulcus syndrome)
V.Parryâ??Romberg syndrome (progressive facial hemiatrophy)
W. Passow syndrome (Bremer status dysraphicus)
X.Raeder syndrome (paratrigeminal paralysis)
Y.Retroparotid space syndrome
ZZ.Silent sinus syndrome
AA.Vernet syndrome (jugular foramen syndrome)
BB.von Herrenschwand syndrome (sympathetic heterochromia)
CC.Wallenberg syndrome (dorsolateral medullary syndrome)
9. Apparent enophthalmos with horizontal conjugate gaze
10. Metastatic adenocarcinoma of orbit (cicatricial)
11. Neurofibromatosis: pulsating enophthalmos
12. Typhoid fever (abdominal typhus)
Albert DM, Jakobiec FA. Principles and practice of ophthalmology. Philadelphia: WB Saunders, 1994:1881â??2095.
Cline RA, Rootman J. Enophthalmos: a clinical review. Ophthalmology 1984;91:229â??237.Bibliographic Links
Roy FH. Ocular syndromes and systemic diseases, 3rd ed. Philadelphia: Lippincott Williams & Wilkins, 2002.
Stasior OG, Roen JL. Traumatic enophthalmos. Ophthalmology 1982;89:1267.Bibliographic Links
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Intraorbital Calcifications
1. Calcification of more irregular configuration and texture
A.Cysticercosis
B.Orbital hematoma
C.Plexiform neurofibroma
D.Toxoplasmosis
E.Tuberculosis
2. Calcification of orbital vessels
A.Atheromatous plaque
B.Monkeberg sclerosis
C.Secondary to metabolic-endocrine disturbances such as hyperparathyroidism or hypervitaminosis
D. Band-shaped keratopathy
3. Chronic inflammatory and parasitic disease of the orbit 4. Hemangiopericytoma
5. Intraocular calcifications following
A.Congenital deformity
B.Malignant lacrimal gland tumor
C.Recurrent iritis and keratitis
D.Retinal detachment
E.Trauma (perforating, nonperforating, or surgical)
6. Intraocular sarcoma
7. Mucocele
8. Myositis ossificans
9. Orbital phleboliths: helical form in veinsâ??smooth, round, or oval 10. Organized hematomas of the orbit
11. *Retinoblastoma
12. Retrolental fibroplasia
13. Sites of intraocular calcification
A.Cyclitic membrane
B.Lens
C.Peripapillary choroid
D.Posterior pole to ora serrata in region of choroid and pigment epithelium
E.Retina
F.Vitreous
Albert DM, Jakobiec FA. Principles and practice of ophthalmology. Philadelphia: WB Saunders, 1994:1881â??2095.
Basta LL, et al. Focal choroidal calcification. Ann Ophthalmol 1981;13:447â??450.Bibliographic Links
Garrity JA, Kennerdell JS. Orbital calcification associated with hemangiopericytoma. Am J Ophthalmol 1986;102:126.Bibliographic Links
Zizmor J, Lombardi G. Atlas of orbital radiology. Birmingham: Aesculapius, 1973.
Diagnostic table
Orbital bruit (noise heard over orbit with stethoscope)
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Orbital Bruit (Noise Heard Over Orbit with Stethoscope)
1. Bilateral
A.Hyperthyroidism
B.Severe anemias
2. Unilateral
A.*Abnormal communication in the cavernous sinus (i.e., bilateral carotid-cavernous sinus)
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B.Aneurysmal angioma of orbit or fundus such as in Wyburnâ??Mason syndrome (Bonnetâ??Dechaumeâ??Blanc syndrome)
C.Arteriovenous aneurysm (arteriovenous fistula)
D.Intermittent or pulsating exophthalmos
E.Stenosis of carotid artery including thrombosis, sclerosis, or external pressure such as that due to an outer-ridge sphenoidmeningioma
Albert DM, Jakobiec FA. Principles and practice of ophthalmology. Philadelphia: WB Saunders, 1994:1881â??2095.
Grobb WE, et al. Facial hamartomas in children: neurofibroma, lymphangioma, and
hemangiomia. Plast Reconstr Surg 1980;66:509.Bibliographic Links
Kushner FH. Carotid-cavernous fistula as a complication of carotid endarterectomy. Ann Ophthalmol 1981;13:979.Bibliographic Links
Lloyd GA. Vascular anomalies in the orbit: C T and angiographic diagnosis. Orbit 1982;1:45.
Orbital Emphysema (Air Found in Orbital Tissues and Adnexa Usually Demonstrable by Palpation)
1. *Due to fracture of ethmoid sinuses or orbital floor 2. Following forceful blowing of nose
3. Injury from compressed air
4. Orbital cellulitis and abscess with gas formation by infecting organism
5. Osteomyelitis and infected sinus with fistulous communication with gas formation by infecting organism
6. Resulting from use of high-speed dental drill and air-water spray during oral operation 7. Subconjunctival emphysema seen with mechanical ventilation
Buckley MJ, et al. Orbital emphysema causing vision loss after a dental extraction. J Am Dent Assoc 1990;120:421â??422.Bibliographic Links
Hunts JH, et al. Orbital emphysema: staging and acute management. Ophthalmology 1994;101:960â??966.Bibliographic Links
Zimmer-Galler IE, Bartley GB. Orbital emphysema: case reports and review of the literature. Mayo Clin Proc 1994;69:115â??121.Bibliographic Links
Orbital Pain
1. Acute dacryoadenitis
2. Amputation neuroma of the orbit
3. Associated syndromes
A.Cavernous sinus thrombosis syndrome
B.Charlin syndrome (nasal nerves syndrome)
C.Erysipelas
D.Ophthalmoplegic migraine syndrome
E.Raeder syndrome (paratrigeminal paralysis)
F.Tolosaâ??Hunt syndrome (painful ophthalmoplegia).
4. Break-bone fever (dengue fever)