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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.
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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 conjproptpsis 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 papilitispapilloedema • Complications menengitis cerebral abscess death • Ttt:masivettt 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 • VitA • 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 (trachomatoustrichiasis ) 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 • Conjxerosis– 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