• Users Online: 366
  • Print this page
  • Email this page

 Table of Contents  
Year : 2019  |  Volume : 57  |  Issue : 3  |  Page : 263-265

Answers to orbit and oculoplasty quiz

Department of Orbit and Oculoplasty, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India

Date of Submission19-Aug-2019
Date of Acceptance27-Aug-2019
Date of Web Publication11-Nov-2019

Correspondence Address:
Dr. Kavitha Ramakrishnan
Doctor's Quarters, C6, Aravind Eye Hospital, Avinashi Road, Civil Aerodrome Post, Coimbatore - 641 014, Tamil Nadu
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tjosr.tjosr_77_19

Get Permissions

How to cite this article:
Ramakrishnan K. Answers to orbit and oculoplasty quiz. TNOA J Ophthalmic Sci Res 2019;57:263-5

How to cite this URL:
Ramakrishnan K. Answers to orbit and oculoplasty quiz. TNOA J Ophthalmic Sci Res [serial online] 2019 [cited 2020 Jul 7];57:263-5. Available from: http://www.tnoajosr.com/text.asp?2019/57/3/263/270708

  Question 1 Top

  • Identify the condition
  • What is the cause
  • What is the treatment?

  Answer Key 1 Top

  • S-shaped ptosis in a young child
  • Suggestive of dermoid cyst – external angular dermoid
  • A dermoid cyst is a congenital choristoma of the orbit
  • When fetal suture lines close during embryogenesis, embryonic epithelial nests may become entrapped and form a cyst
  • After ruling out intracranial extensions, total excision of the cyst.

  Question 2 Top

  • What is the differential diagnosis
  • Treatment options
  • Prognosis.

  Answer Key 2 Top

  • Differential diagnosis

    1. Orbital fat prolapse
    2. Conjunctival cyst
    3. Pseudotumor
    4. Conjunctival lymphoma

  • Diagnosis is conjunctival lymphoma
  • Incisional biopsy to confirm the diagnosis
  • Oncologist referral
  • Rule out distant metastasis
  • External beam radiotherapy is the treatment of choice
  • 20–50 Gy are used, with fractionated treatment over 15 sessions
  • Overall, prognosis is generally good, with 90% of patients not experiencing progression or recurrence during 1-year follow-up periods.

  Question 3 Top

  • What is the diagnosis
  • What is the name of the radiological sign
  • What are the treatment options?

  Answer Key 3 Top

  • Blow-out fracture of the orbit
  • Occurs when a blunt object greater in diameter than the orbital rim such as fist, cricket, or tennis ball hits the orbit with force
  • Mechanisms proposed are hydraulic and buckling theory
  • Teardrop or hanging drop sign – Discontinuation of the orbital floor with herniation of soft tissue into the maxillary antrum
  • Early period can consider oral steroids, if persistent diplopia and enophthalmos after 2 weeks surgical treatment, release muscle entrapment, and use implants such as medpore and titanium.

  Question 4 Top

  • Identify this condition
  • What is the cause
  • What is the treatment?

  Answer Key 4 Top

  • Canaliculitis, which is an infection of the lacrimal canaliculus, typically occurs in individuals over 40 years of age
  • Actinomyces israelii (an anaerobic filamentous Gram-positive bacteria) is the most common pathogen
  • Less common pathogens include Candida albicans, Nocardia asteroides, Aspergillus, herpes simplex virus, and varicella-zoster virus
  • Infection causes small dacryoliths, or stones, to form, which are concretions consisting of sulfur granules
  • Three-snip ampullotomy with curettage and concretion removal with or without intubation.

  Question 5 Top

  • Diagnose this condition
  • Hallmark radiological finding
  • Treatment options.

  Answer Key 5 Top

  • Orbital venous-lymphatic malformation (lymphangiomas)
  • Key diagnostic features
  • A multilobulated, septated, trans-spatial cystic appearing lesion is seen. Fluid–fluid levels suggestive of intralesional hemorrhage can be seen. Enhancement is variable. No flow voids are associated with this lesion
  • Differential diagnosis – Hemangioma
  • Surgery for decompression and cosmetic purposes
  • Recent therapy is sclerotherapy, commonly using intralesional injection bleomycin.

  Question 6 Top

  • Identify the systemic condition
  • Hallmark radiological feature
  • Treatment of choice.

  Answer Key 6 Top

  • Dysthyroidism
  • Associated most commonly with hyperthyroidism and less commonly with hypothyroidism and euthyroid status
  • Proptosis with enlargement of muscles. A key feature to differentiate from myositis is sparing of tendinous insertion of the muscle
  • Supportive measures and conservative treatment in mild and mild-to-moderate thyroid eye disease along with endocrinologist management
  • Pulse steroid therapy with intravenous methyl prednisolone in moderate-to-severe and severe thyroid eye disease according to the EUGOGO Recommendations.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.


Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

  In this article
Question 1
Answer Key 1
Question 2
Answer Key 2
Question 3
Answer Key 3
Question 4
Answer Key 4
Question 5
Answer Key 5
Question 6
Answer Key 6

 Article Access Statistics
    PDF Downloaded49    
    Comments [Add]    

Recommend this journal