Orbital granuloma
This is an immune mediated disorder of the orbit caused by a diffuse granulomatous infiltrate of lymphocytes and plasma cells in the orbital fat and external ocular muscles.
Features:
- sudden onset of orbital pain with lid oedema
- proptosis
- chemosis
- ophthalmoplegia
It usually occurs in middle age and is rarely bilateral.
CT reveals a diffuse orbital lesion which may be confirmed by biopsy.
Treatment is initially by steroids eg. prednisolone. If this is unsuccessful, try radiotherapy.
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