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Optic Neuropathies Associated with Systemic Disorders And Radiation-Induced Optic Neuropathy
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Ocular involvement is seen in approximately 50–60% of GPA patients and 8% of affected individuals experience disease-related vision loss (10). Any part of eye may be affected, albeit the condition most often manifests as orbital disease, followed by scleral, episcleral, corneal and nasolacrimal abnormalities (10). Early recognition of the ocular features can be pivotal to identifying active disease, and preventing vision loss. Optic nerve involvement may develop from contiguous inflammation in the setting of orbital inflammation, or local compression (1). When orbital disease occurs, it can extend from its origin in the maxillary or ethmoid sinuses, and spread to involve the extraocular muscles, nerves or blood vessels (1, 10). Alternatively, inflammation can arise in the orbit, and spread throughout the retrobulbar space (1, 10). Patients may present with proptosis, ocular motility deficits and pain (1). In some cases, affected individuals develop exposure keratopathy and corneal ulceration, which in turn, leads to permanent vision loss.
Management of Ophthalmic Injuries by the Forward Surgical Team
Published in Mansoor Khan, David Nott, Fundamentals of Frontline Surgery, 2021
Richard J. Blanch, Johno Breeze, William G. Gensheimer
A haematoma in the orbit or (often) in the subperiosteal space may increase intraorbital pressure sufficiently to impair blood supply to the eye and optic nerve. This may or may not be associated with orbital fractures.
Anatomy of the head and neck
Published in Helen Whitwell, Christopher Milroy, Daniel du Plessis, Forensic Neuropathology, 2021
The orbit is a pyramidal, bony cavity in the face. It contains and protects the eye with its associated muscles, nerves and vessels and the lacrimal apparatus. The roof is formed by the orbital part of the frontal bone, separating the orbit from the anterior cranial fossa and containing a small fossa for the lacrimal gland. The lesser wing of the sphenoid contributes to the roof at its apex. The medial wall is formed by the thin bone of the ethmoid, frontal, lacrimal and sphenoid bones. It is indented by the fossa of the lacrimal sac and nasolacrimal duct. The lateral wall comprises the frontal process of the zygomatic bone and the greater wing of the sphenoid, and is vulnerable to direct trauma. It serves to separate the orbit from the temporal and middle cranial fossae. The floor is made up from the maxilla, zygomatic and palatine bones, with a thin inferior wall partly separated from the lateral wall by the inferior orbital fissure. At the apex of the orbit lies the optic canal, located medial to the superior orbital fissure, which carries the optic nerve and associated structures into the orbit.
Psychosocial factors among patients undergoing orbital exenteration
Published in Clinical and Experimental Optometry, 2023
Neelima Balakrishnan, Sahil Agrawal, Rachna Bhargava, Veena Jain, Neelam Pushker, Rachna Meel, Mandeep S. Bajaj
The human face establishes the identity of a person in society. Its normalcy is an important factor for self-confidence, communication, developing interpersonal relationships and for overall well-being. Exenteration is a procedure that involves removal of contents of the orbit including appendages. It is mostly done in locally advanced malignancies that are not amenable to any other treatment as a life-saving procedure as seen in the present study also.3,4 There are several reports on psychosocial challenges associated with the cancer patients.5,6 Facial disfigurement related to destructive surgeries such as enucleation, evisceration and exenteration, adds on to the trauma due to associated social stigma leading to a functional, social, personal and financial setback.1,7 Though there are several reports available on the psychosocial issues in one-eyed patients, patients who underwent evisceration, enucleation, or had disfigurement due to facial trauma but the literature is scarce on the psychosocial impact and quality of life in patients who underwent exenteration.7 Furthermore, to the best of the knowledge, there is no prospective comparative study on pre-operative and post-operative changes in severity of psychosocial issues, quality of life and its difference with the patients wearing prosthesis post-exenteration.
Surgical removal of orbital tumors by orbital approach using ultrasonic surgical system SONOPET®
Published in Orbit, 2022
Álvaro Bengoa-González, María-Dolores Lago-Llinás, Enrique Mencía-Gutiérrez, Agustín Martín-Clavijo, Elena Salvador, Mónica Gimeno-Carrero
Orbital tumors are alarming to most patients because they threaten their most valuable sensory organ. The orbit can harbor a variety of benign and malignant tumors that often lead to eye displacement, impaired motility, diplopia, visual field defects, or compression of the optic nerve (ON) leading to complete loss of vision.1 Surgery of orbital tumors can be challenging as it is carried out in a very narrow surgical field, and in close proximity to important structures that need to be spared. The correct surgical approach is essential to removing the tumor with no collateral damage; however, this is not always possible due to the anatomical location, and difficult access, along with adhesions and loss of normal anatomy from previous surgeries. These, in turn, increase the risk of damage to critical structures such as the optic and oculomotor nerves, as well as extraocular muscles.1,2
Current clinical diagnosis and management of orbital cellulitis
Published in Expert Review of Ophthalmology, 2021
Sara A. Khan, Ahsen Hussain, Paul O. Phelps
Orbital cellulitis exists within a continuum of inflammatory diseases of the orbit and neighboring structures. It is important to emphasize that these diseases mostly exist as discrete pathologies and only rarely manifest as progressive diseases [36] (Table 1). One of the first widely utilized classification systems to understand orbital cellulitis was created by Chandler et al., which defined the diseases of the orbit into five categories [26,28]. The main anatomical landmark for differentiating the five diseases is the orbital septum. The orbital septum is continuous with the periosteum of the orbital rim (arcus marginalis) and connects anteriorly to the tarsal plate [12]. It contains the orbital contents, provides structural support, and prevents extension of superficial infections into the post-septal space [25,37]. Preseptal cellulitis is more specifically defined as infection of the eyelid with a known infection source and exists anterior to the orbital septum [38,39]. Within the original Chandler classification, Chandler I was defined as ‘inflammatory edema’ caused by obstruction of venous blood flow due to sinus congestion [28,38]. Preseptal cellulitis is often defined as ‘Chandler I’ in some literature, and in this study, we will define Chandler I as ‘inflammatory edema.’