1. In The Name of Good

2. І:Disorder of orbit
Introduction
• Pear shaped
• Optic nerve (18 &25)
• 4 wall (2&2*3*4)

3. B:clinical signs
a:soft tissue involvement
• Lid&periorbital edema
• Ptosis
• Chemosis,ingection

4. Proptosis
Axial
Non Axial
Pseudoproptosis

5. Enophthalmos
• Smal glob-congenital
anomaly
• Structral bony
abnormality-blow-out
fracture
• Atrophy of orbital content
• Cicatrizing orbital lesion

6. Ophthalmoplegia
• An orbital mass
• Restrictive
myopathy(Graves or
myosit)
• Ocular motor nerve
lesion(tolosa-Hunt,
fistula)
• Tethrering (entrapment in
blow –out fracture
• Splinting of optic
nerve(meningioma)

7. Visual dysfunction
• Exposur
keratopathy(Proptosis)
• Opticneuropathy
• (compressive)
• Chroidal fold

8. Dynamic propertis
• Increasing venous
pressure(valsalva)-
Hemangioma
• Pulsation(A.V.Commu
nication)
• Bruit(C.C.fistula)

9. Fundus changes
• A.optic
atrophy(compressive)
• B.optociliary shunt
• C.chroidal fold
• D.retinal vascular
changes

10. џ :accute orbital inflamation
Epidemiology
• A-rare
• B-very important
• C-life threatening

11. classification
• Preseptal
• Orbital

12. Cause
• A-most cases(>
60%)adjacent sinus
• B- most common
H.inflou inchild<5
year
• C-most common
staph.sp & streptsp

13. symptoms
• A-Decreas vision
• B-pain & redness
• C-Tearing
• D-Swelling/pressure
• E-Blurred vision
• F-Diplopia

14. signs
• A-redness of lids
• B-chemosis
• C-lid swelling
• D-
exophthalmos(proptosis)
• E-ocular motility problem
• F-appearance of acute
systemic illness

15. Investigation
A-History(sinusitis,
systemic complaints)
B- ocular examination
C-general examination
D-special examination

16. Associated features
• A-fever
• B-leukocytosis
• C-orbital apex
syndrom
• D-cavernous sinus
thrombosis
• E-meningitis

17. pathology
• A-neutrophils
• B-necrosis
• C-causative agent

18. Differential diagnosis
• A-graves diseas
• B-allergic reaction(angio
neurotic edema)
• C-pseudotumor
• D-parinaud’s
oculoglandular syndrom
• E-wegener;s
granulomatosis
• F-mucocel
• G-orbital Neoplasm
• H-caroid cavernous fistula

19. Complications
• A-visual loss
• B-ocularmotility
problem
• C-orbital apex
syndrom
• D-meningitis

20. Treatment aim
• A- to preserre ocular
vision & function
• B-to avoid postspread
• C-to identify
underlying
diseas(diabet,diarrhea,
acidosis)

21. Treatment
Diet & lifestyle
• A-bedrest
• B-warm compresses
• C-light diet

22. Pharmacologic Treatment
• A-culture purulent
material
• B-most children systemic
antibiotic
• C-adult gram-stain.d &
systemic antibiotic
• D-if cavernous sinus
thrombosis(prompt.
Antibiotic)
• E-phycomycosis(intra
venous Antibiotic)

23. Non pharmacologic Treatment
• A-if
sinusitis,otitis,dental
Abcess
• B-drain purulent
material
• C-blood cultures

24. Prognosis
• A- With prompt
Antibiotic & drainage
• B-excellent
rehabilitation of visual
& ocular

25. F/U
• A-close f/u
• B- needs drainge
• C- systemic diseas
control

26. ш:chronic orbital inflamation
*epidemiology
• Rarre
• (mucormycosis)

27. causes
• Granulomatous
(tb,aspirg ,parasit
,wegne)
• Parinaud
• Unknown cause
• Life threatening
• (pseudotumor orbit )

28. classification
• Infectious granulomat
• Noninfectious G.R
• Noninfectious non,GR

29. symptoms
• Exophthalmos
• Red,painful eye
• Swellingpressure
• (tearing,blurred
vision,diplopia)

30. 30:signs
• Exophthalmos
• Chemosis,injection
• Periorbital&eyelid
edema
• Lid lag
• Ocular motility
problem

31. Investigation
• History(leukemia,sarc
oidosis,immunosuppre
• Ocular examination
• Grave diseas
sarcoidosis
• Infectious agent
• General examination
• Special examination

32. 32:Immunology
• Not determined
certainly in all cases

33. 33:associated feature
• Depend on cause
(multisyst
eminvolvment
,sarcoidosis)

34. 34:differential diagnosis
• Grave diseas
• Acute orbital
inflamation
• Orbital mucocel
• Carotid cavernous
fistula
• Orbital neoplasm

35. 35:complication
• Exposure keratitis
• Visual loss
• Uveitis
• Intraocular involveme
• Strabismus,diplopia
• Systemic involvement,
&even death

36. 36-Treatment aim
• A-to presure visal &
ocular function
• B- to identify & treat
underlying systemic
diseas

37. Diet & life style
• A-No special
precautions
• B-in acutly ll.(bedrest-
warm compressos 7
specifie treatment)

38. Pharmocological Treatment
• A-Antibiotic in
infectious diseas
• B lubricating in
exposure keratitis
• C local or systemic
management of main
cause

39. 39:nonpharmacologic treatment
• Orbital biopsy
• Corticosteroid
• Low-dose radiation

40. 40:prognosis is good
• Prompt appropriat
treatment
• Consultaation
(E,N,T,pediaterician,o
ral surgen,internist)

41. F/U
• Initial close F/U
• Long-term F/U