Orbital pseudotumor

Background

  • Also known as idiopathic orbital inflammation
  • Swelling of any area of the orbit
  • Diagnosis of exclusion
  • Chronic condition characterized by orbital sclerosis and relapses[1]

Clinical Features

  • Proptosis[2]
  • Chemosis
  • Cranial nerve palsy
  • Diplopia
  • Pain

Differential Diagnosis

Periorbital swelling

Proptosis

No proptosis

Lid Complications

Other

Evaluation

  • CT Orbit with IV contrast
    • Evaluate for tumor vs infectious etiology
    • Imaging findings may be similar to orbital cellulitis
  • MRI orbit gold standard

Management

Vancomycin 15-20mg/kg IV BID + (one of the following)

Consults

  • Ophthalmology

Disposition

  • Discharge with close ophthalmology followup

Complications

  • Vision loss
  • Oculomotor dysfunction

References

  1. Rubin, P. A. D. and Foster, S. C. (2004) ‘Etiology and management of idiopathic orbital inflammation’, American Journal of Ophthalmology, 138(6), pp. 1041–1043.
  2. Yuen, S. A. J. (2003) ‘Idiopathic Orbital Inflammation’, Archives of Ophthalmology, 121(4).