2014-2015 Basic and Clinical Science Course (BCSC): Section by American Academy of Ophthalmology, John Bryan Holds MD

By American Academy of Ophthalmology, John Bryan Holds MD

Info the anatomy of the orbit and adnexa, and emphasizes a pragmatic method of the evaluate and administration of orbital and eyelid issues, together with malpositions and involutional alterations. Updates present details on congenital, inflammatory, infectious, neoplastic and tense stipulations of the orbit and accent constructions. Covers key points of orbital, eyelid and facial surgery.

Upon crowning glory of part 7, readers could be capable to:

Describe the traditional anatomy and serve as of orbital and periocular tissues
Choose applicable exam options and protocols for diagnosing problems of the orbit, eyelids, and lacrimal system
Describe sensible and beauty symptoms within the surgical administration of eyelid and periorbital stipulations

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Additional resources for 2014-2015 Basic and Clinical Science Course (BCSC): Section 7: Orbit Eyelids and Lacrimal System

Sample text

D t- e r- Pathology The diagnosis of an orbital lesion usually requires analysis of tissue obtained through an orbitotomy. Appropriate handling of the tissue specimen is necessary to ensure an accurate diagnosis. The majority of tissue samples are placed in formalin for permanentsection analysis. Frozen-section analysis is generally not used for definitive diagnosis of an orbital tumor. However, when the area of proposed biopsy is not obvious, frozen sections are helpful to confirm that appropriate tissue has been obtained for permanent-section analysis.

21 II • 22 • Orbit, Eyelids, and Lcjcrimal System . Table 2-1 Periorbital Changes Associated With Orbital Disease Sign Etiology A salmon-colored mass in the cul-de-sac Eyelid retraction and eyelid lag Vascular congestion over the insertions of the rectus muscles (particularly the lateral rectus) Corkscrew conjunctiva! vessels Vascular anomaly of eyelid skin Lymphoma (see Fig 5-14) Thyroid eye disease Thyroid eye disease (see Fig 4-5A} S-shaped eyelid Eczematous lesions of the eyelids Ecchymoses of eyelid skin Prominent temple Edematous swelling of lower eyelid Optociliary shunt vessels on disc Frozen globe Black-crusted lesions in nasopharynx Facial asymmetry Arteriovenous fistula (see Fig 4-5B) Lymphangioma, varix, or capillary hemangioma Plexiform neurofibroma or lacrimal gland mass (see Fig 5-7) Mycosis fungoides (T-cell lymphoma) Metastatic neuroblastoma, leukemia, or amyloidosis Sphenoid wing meningioma, metastatic neuroblastoma (see Fig 5-9A} Meningioma, inflammatory tumor, metastases Meningioma Metastases or zygomycosis Phycomycoses Fibrous dysplasia or neurofibromatosis (see Fig 5-12A} Physical Examination Special attention should be given to ocular motility, globe position, pupillary function, and ophthalmoscopy.

Ducts from both lobes pass through the palpebral lobe and empty into the upper conjunctiva! fornix temporally. Frequently, a portion of the palpebral lobe is visible on slit-lamp examination with the upper eyelid everted. rformed on the palpebral lobe or temporal conjunctiva! fornix because it can interfere with the lacrimal ductules draining the orbital lobe. With age, the orbital lobe of the lacrimal gland may prolapse inferiorly out of the fossa and present as a mass in the lateral upper eyelid.

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