Orbital tumor
- Tumor that may arise in orbit, reach it by local extension from paranasal sinuses, or reach it by metastasis through blood stream
- Diagnosis depends on imaging and sometimes biopsy
- Treatment and outcome depend on nature of tumor
- Proptosis
- Displacement of eye
- Pain
- Diplopia
- Vision loss
- Reduced eye movement
- Ptosis
- Mildly engorged conjunctival vessels
- Orbital cellulitis causes relatively more lid swelling and less proptosis
- Conjunctivitis causes more engorgement of conjunctival vessels and no proptosis
- Contact dermatitis affects only lids and surrounding facial skin
- Stye causes focal swelling and tenderness mainly affecting one lid
- Dacryocystitis causes focal swelling and tenderness of nasal portion of lower lid, where lacrimal sac lies
- Anterior uveitis causes photophobia
- Scleritis usually causes focal conjunctival redness and more periocular pain
- Idiopathic orbital inflammation, but orbital imaging should make distinction
- Graves disease, but should have lid retraction and lag
- Cavernous sinus arteriovenous fistula, but should have dilated superior ophthalmic vein on imaging
- Order orbital CT or MRI to determine location and extent of tumor
- Refer to ophthalmologist urgently for further management, which involves determining source of tumor and deciding on biopsy
- Outcome depends on nature of tumor