Orbital Conditions Diagnosis and Surgery

 

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The orbit is the area between the eyeball and the bony socket around it. There are many structures in this area. Common problems of the orbit include fractures of the bony wall, tumours of any of the structures, infection and inflammation of the orbit.

There is a cushion of fat all around the eyeball that absorbs the impact on the eyeball when we make small movements of the head. Within this fat, there are blood vessels, nerve tissue, muscle and glands. In front of the eyeball are the tissues of the eyelid which have hair follicles and skin. Diseases of any of these structure can affect the function of the eyeball and as a consequence, vision may be affected. Some of these problems may be life threatening.

Symptoms are:

  • Pain of the eye and surrounding area
  • Swelling or protrusion of the eye within the socket
  • Eye Redness
  • Tearing
  • Eye Irritation or Eye strain
  • Blurred vision
  • Swelling of the eyelid
  • Double vision

Investigations may often include blood and hormone tests, CT scans or MRI scans of the eye and brain regions.

If there is a lump noted during investigation, a biopsy of the lump for a more accurate diagnosis will be required. Treatment often depends on the type of lesion, there may be no further intervention for benign lesions like a cavernous haemangioma (benign blood vessel tumour) or Chemotherapy and radiotherapy for tumours like lymphomas.

Orbit/Eye injuries:

Trauma around the eye socket region is common. Causes may include falling, sports injuries or chemical splashes.First aid includes the following:

Falling debris in the eye

  1. Do not rub eye
  2. Flush eye with large amounts of water
  3. See a doctor

Cuts, Punctures, lacerations, hammering injuries

  1. Do not remove foreign object stuck in the eye
  2. Do not wash out the eye
  3. Go to an eye doctor immediately

Chemical injuries

  1. Immediately flush the eye with water for 15 mins.
  2. For Caustic acids of alkaline solutions continue washing while on the way to clinic
  3. Go to an eye doctor immediately

Blunt injuries to the eye

  1. Apply cold compress without pressure
  2. See a doctor

If the eyeball is involved and there is an open injury immediate repair will be required. When there is a closed injury, treatment is with eyedrops and close monitoring for retina holes and tears.

Fractures of the bony eye socket can lead to eye ball “sinking in” or double vision. The bony framework that support the delicate eyeball will be weakened and repair may be required. If there is poor alignment of the cheek bones, these will need to be repaired as well.