Presentation
Other patients presented demonstrate the strong familial trend of neurofibromatosis, the multiplicity of lesions, the progression of lesions. [ncbi.nlm.nih.gov]
Presentation : these variably present from early childhood (especially lymphangiomas) to adulthood. Varices present with intermittent proptosis (evident in the Valsalva manoeuvre) ± visible lesions in the eyelid. [patient.info]
Three patients in our study presenting with proptosis were proved to be metastases in the orbit. [ijri.org]
Entire Body System
- Swelling
Complete or partial dislocation from the orbit is also possible from trauma or swelling of surrounding tissue resulting from trauma. [icd.codes]
However, there is a relatively small amount of redundant space and so any swelling within these tissues rapidly results in forward displacement of the globe ± bulging out of the tissues themselves. [patient.info]
[…] pulsating exophthalmos with cerebral blood-flow maintained through external carotid artery. ( 14930044 ) Falconer M.A....Hoare R.D. 1952 30 Unilateral pulsating exophthalmos associated with multiple bony tumours (some pulsating) and nodular thyroid swelling [malacards.org]
Skull base fractures often accompany the bleeding in the soft tissues of the head which are expressed through some bruising and swelling of eyelid (raccoon sign), ganglion hematoma, bruising in the mastoid area (Battle sign), hemotimpan signs (blood located [medicaldb.blogspot.com]
It should be carried out for retrodisplacement of globe to know compressibility of the tumour, for orbital thrill, for any swelling around the eyeball, regional lymph nodes and orbital rim. 3. Auscultation. [ikeyes.blogspot.com]
Musculoskeletal
- Fracture
Hip Fracture Prevention in Older Adults in 2019 This JAMA Insights Clinical Update reviews approaches to fracture prevention in older adults, including estimating fracture risk and life expectancy, selecting and managing appropriate medications, an... [bioportfolio.com]
Skull fractures and directs the production mechanism of trauma intensity. Skull fractures are classified as follows: - Fracture of skull vault. These in turn can be: linear fractures, burst fractures and fracture dehiscence. [medicaldb.blogspot.com]
Articles will include: Optimizing craniofacial CT technique, Orbital and facial fractures, Orbital and facial soft tissue injuries, Skull base fractures and their complications, Temporal bone trauma, Pediatric considerations in craniofacial trauma, Cerebrovascular [books.google.com]
He suffered a skull base fracture, multiple facial fractures including bilateral medial and inferior orbital wall fractures, bilateral orbital roof fractures and a left lateral orbital wall fracture. He presented with multiple brain hemorrhages. [healio.com]
[…] is a clinical symptom characterized by protrusion and pulsation of the eyeball that can occur due to various causes: caroticocavernous fistulas neurofibromatosis type 1 (with sphenoid wing dysplasia ) 2 arteriovenous malformation trauma (orbital roof fractures [radiopaedia.org]
Eyes
- Lacrimation
H04.162 Lacrimal gland dislocation, left lacrimal gland H04.163 Lacrimal gland dislocation, bilateral lacrimal glands H04.169 Lacrimal gland dislocation, unspecified lacrimal gland H04.19 Other specified disorders of lacrimal gland H04.201 Unspecified [app.drchrono.com]
ICD-10-CM Codes › H00-H59 Diseases of the eye and adnexa › H00-H05 Disorders of eyelid, lacrimal system and orbit › H05- Disorders of orbit › Pulsating exophthalmos, left eye 2016 2017 2018 2019 Billable/Specific Code H05.262 is a billable/specific ICD [icd10data.com]
There were missing of orbital plate of the fronral bone, lesser and great wing of the sphenoid, and lacrimal plate of the ethmoid bone. [jkns.or.kr]
Lacrimal gland carcinoma This is a rare tumour presenting in the fourth to sixth decades of life with a long-standing proptosis (± swollen upper lid) which suddenly starts to increase, or as a rapidly growing (over months) lacrimal gland mass. [patient.info]
Proptosis associated with a soft-tissue mass, and thickening of the extraocular muscles and the right lacrimal gland were present in the right orbit [Figure 5]. [meajo.org]
- Diplopia
Presentation : proptosis, dystopia, diplopia and epiphora (excess tears). There may be tenderness over the affected sinus. [patient.info]
Extraocular motility dysfunction and diplopia should be carefully assessed and documented. Forced duction testing may qualify the dysfunction as restrictive or neurogenic in nature. [emedicine.medscape.com]
Trohlear nerve damage by small wing of sphenoid fracture is seen clinically with diplopia only when looking down. [medicaldb.blogspot.com]
Other causes include choroidal detachment, diplopia, proptosis with corneal exposure, macular edema, venous stasis retinopathy, or retinal or optic nerve ischemia. [healio.com]
[…] approximately 30 to 50 percent of patients with thyroid disease have ophthalmic manifestations, of which only 3 to 5 percent of the patients constitute the vision-threatening spectrum of the disease. 7 Patients will commonly present with complaints of diplopia [reviewofophthalmology.com]
- Unilateral Proptosis
CLASSIFICATION Proptosis can be divided into following clinical groups: Unilateral proptosis Bilateral proptosis Acute proptosis Intermittent proptosis Pulsating proptosis ETIOLOGY Important causes of proptosis in each clinical group are listed here: [ikeyes.blogspot.com]
- Conjunctival Injection
Red eye - conjunctival injection increases with the exophthalmos. In severe cases, there may be a secondary exposure keratopathy as a result of incomplete lid closure over the cornea. [patient.info]
- Excessive Tearing
Presentation : proptosis, dystopia, diplopia and epiphora (excess tears). There may be tenderness over the affected sinus. [patient.info]
Neurologic
- Papilledema
Dilated fundus exam: OD—normal fundus; OS—grade 3 papilledema with palor (see Figure 3) Figure 1 : Multiple café au lait spots Figure 2 : Axial pigmentation and freckling was apparent on exam Figure 3 : Papilledema and palor of the optic disc are observed [webeye.ophth.uiowa.edu]
Dural arteriovenous malformations and papilledema. Neurosurgery 1988; 22 : 1079–1084. [nature.com]
Common signs of CCF include proptosis, temporal/orbital bruit, chemosis, extraocular palsy, pulsating exophthalmos, elevated IOP, anterior segment ischemia, papilledema, optic nerve atrophy and trigeminal nerve involvement. [healio.com]
- Nystagmus
H5502Latent nystagmus H5504Dissociated nystagmus H5581Saccadic eye movements H5700Unspecified anomaly of pupillary function H5702Anisocoria H5703Miosis H5704Mydriasis H57051Tonic pupil, right eye H57052Tonic pupil, left eye H57053Tonic pupil, bilateral [cms.gov]
FRACTURES stones can cause bone and VIII cranial nerve injury, resulting in hearing loss, vertigo and nystagmus immediately after the injury. [medicaldb.blogspot.com]
No response to Optokinetic Nystagmus (OKN) drum testing in OS. Extraocular motility: Flick of intermitent exophoria, OS, in primary gaze. Slightly impaired upgaze, OS. Pupils: 6 mm in dark, 3 mm in light, OD. Only consensual response to OS. [webeye.ophth.uiowa.edu]
Workup
The phase of the disease will then ultimately determine the indicated workup and treatment. Differential Diagnosis Depending on the presenting symptoms, further workup can be necessary to rule out other possible diagnoses. [reviewofophthalmology.com]
Treatment
[…] sinus fistulas and their treatment with balloon catheters 205 Closure of carotidcavernous fistulas by intracavernous surgical insertion of biological materials 211 Carotid cavernous aneurysms and fistulas 225 [books.google.com]
L. : Specific treatment of intracranial aneurysms. Experiences with 143 surgically treated patients. J. Neurosurg. 8 ( 1951 ), 75. Google Scholar | Medline [journals.sagepub.com]
The diagnosis and treatment of thyroid-associated ophthalmopathy. Aesth Plast Surg 2012;36:638-648. 11. Stan MN, Garrity JA, Bahn RS. The evaluation and treatment of Graves’ ophthalmopathy. Med Clin N Am 2012;96:311-328. 12. [reviewofophthalmology.com]
Treatment is via surgical excision. [patient.info]
Prognosis
Late facial paralysis is usually a better prognosis than the paralysis that occur immediately. FRACTURES stones can cause bone and VIII cranial nerve injury, resulting in hearing loss, vertigo and nystagmus immediately after the injury. [medicaldb.blogspot.com]
Visual prognosis in carotid-cavernous fistula. Arch Ophthalmol. 1981;99(9):1600-1603. [healio.com]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
Manifestation code identifies conditions for which it is important to record both the etiology and the symptom of the disease. [books.google.com]
Otorhinolaryngological examination is necessary when the paranasal sinus or a nasopharyngeal mass apears to be a possible etiological factor. II. [ikeyes.blogspot.com]
A etiologic factors include trauma, surgery, infection, and sinus thrombosis. 3, 4, 5 The clinical presentations of DAVMs depend on the location of the DAVM and include tinnitus, cranial nerve palsies, and/or signs related to venous congestion in the [nature.com]
Proptosis, chemosis, episcleral venous congestion Given that trauma is the etiology of the patient’s signs and symptoms, the differential diagnosis becomes quite narrow. [healio.com]
Epidemiology
Epidemiology and prevention of Graves' ophthalmopathy. Thyroid. 2002 Oct. 12(10):855-60. [Medline]. Putta-Manohar S, Perros P. Epidemiology of Graves' orbitopathy. Pediatr Endocrinol Rev. 2010 Mar. 7 Suppl 2:182-5. [Medline]. [emedicine.medscape.com]
The epidemiologic characteristics and clinical course of ophthalmopathy associated with autoimmune thyroid disease in Olmsted County, Minnesota. Trans Am Ophthalmol Soc 1994;92:477-588. 4. Stan MN, Bahn RS. [reviewofophthalmology.com]
Diagnosis: Optic nerve glioma associated with Neurofibromatosis Type 1 EPIDEMIOLOGY of NF1 Rare condition (1 per 3-4,000 people) characterized by hamartomas of neural crest origin Autosomal dominant inheritance Variable expressivity, 100% penetrance Half [webeye.ophth.uiowa.edu]
Pathophysiology
Decreased vision - visual acuity may be impaired by: Direct optic nerve involvement due to the pathophysiology. Distortion of the macula by a lesion pushing in behind the globe. Exposure keratopathy (see above) can also affect the visual acuity. [patient.info]
The pathophysiology of thyroid eye disease: implications for immunotherapy. Curr Opin Ophthalmol. 2011 Sep. 22 (5):385-90. [Medline]. Ugradar S, Rootman DB. Case Series: Noninflammatory Thyroid Eye Disease. [emedicine.medscape.com]
Prevention
Hip Fracture Prevention in Older Adults in 2019 This JAMA Insights Clinical Update reviews approaches to fracture prevention in older adults, including estimating fracture risk and life expectancy, selecting and managing appropriate medications, an... [bioportfolio.com]
Early detection and treatment could prevent vision loss. See an eye care professional right away if you have a sudden change in vision, if everything looks dim, or if you see flashes of light. [icdlist.com]
In hypothermic patients, I found cardiac arrhythmias could be induced by manipulation of vessels of the Circle of Trellis as well as by other stimuli and could be prevented or alleviated by IV sodium pentathal JNS, 1958). Microsurgery. [neurosurgery.org]
Prevent and plan for complications in advance by examining over 1,600 illustrations, photos and graphics (1,250 in color) capturing essential diagnostics techniques, imaging methods and surgical approaches. [books.google.com]
Despite the benefits, the side-effect profile of corticosteroids prevents their long-term use. [reviewofophthalmology.com]