2008-2009 Basic and Clinical Science Course: Section 7: by John Bryan Holds, MD

By John Bryan Holds, MD

Emphasizing a pragmatic method of prognosis and remedy, this quantity summarizes present details on congenital, infectious, inflammatory, neoplastic, and worrying stipulations of the orbit and adnexa. Highlights contain huge dialogue of thyroid-associated orbitopathy, lymphoproliferative problems, and eyelid neoplasms. comprises up-to-date references and diverse new colour pictures.

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Extra resources for 2008-2009 Basic and Clinical Science Course: Section 7: Orbit, Eyelids, and Lacrimal System (Basic and Clinical Science Course 2008-2009)

Sample text

Imaging studies should be performed to rule out underlying sinusitis if no direct inoculation site is identified. If the patient does not respond quickly to oral antibiotics or if orbital involvement becomes evident, prompt hospital admission, CT, and IV antibiotics are usually indicated. Surgical drainage may be necessary if preseptal cellulitis progresses to a localized abscess. Incision and drainage can usually be performed directly over the abscess, but care should be taken so that damage to the levator aponeurosis in the upper eyelid is avoided.

Usually, the globe is uninvolved. Pupillary reaction, visual acuity, and ocular motility are not disturbed. Pain on eye movement and chemosis are absent. Designating the cellulitis as preseptal implies an infective process superficial to the orbital septum, one typically requiring less-intensive treatment than orbital cellulitis. Although preseptal cellulitis in adults is usually due to penetrating trauma or a cutaneous source of infection, in children the most common cause is underlying sinusitis.

Ophthalmology. 1997; 104: 1857 -1862. Shayegani A, MacFarlane 0, Kazim M, Grossman ME. Streptococcal gangrene of the eyelids and orbit. Am J Ophthalmol. 1995;120(6):784-792.

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