The orbit of the eye or the eye socket is the bony hollow structure which houses the eye as well as the associated anatomical structures. Various disorders can affect the eye. The orbit can get infections, inflammation, fractures, tumors etc. various diseases like Grave’s disease can also affect the eye orbit.
The infection of the eye orbit can be of two types. Preseptal cellulitis which occurs around the eyes or Orbital cellulitis which occurs within the socket of the eye. Both type of infection are more common in children as compared to adults. Preseptal cellulitis occurs more frequently as compared to orbital cellulitis. Between the two types, orbital cellulitis is considered to be more dangerous.
Preseptal cellulitis or periorbital cellulitis is the infection in the tissues around the eyes and inside the eyelids. It is caused by an infected animal bite or insect bite, a progressive infection of the face or eyelids, conjunctivitis or sinusitis. The infection causes the area around the eye to become tender, swollen and red. The swelling may be to the extent where it is difficult for the person to open the eye. The patient might also develop a fever. Once the eye is opened, vision and movement of the eye are not impaired and the eyeball is also not bulging. The condition is diagnosed by physically examining the symptoms of the patients but sometimes an MRI or CT scan may have to be done to check for the possibility of the more dangerous orbital cellulitis. The treatment is done by oral or intravenous antibiotics under close supervision of an ophthalmologist.
Orbital cellulitis is an infection which can be spread to the eye orbit from areas such as the nasal sinuses or from teeth or bloodstream. This infection affects the tissue within the orbit as well as behind the eyes. Orbital cellulitis causes swelling, redness of the eyes, bulging eyes, pain, impaired movement of the eyes and impaired vision as well. The antibiotics for the treatment are administered by vein. If not treated properly, orbital cellulitis can cause permanent loss of vision. The infection can spread from the eye to brain and spine or lead to formation of blood clots which can eventually lead to a condition called Cavernous Sinus Thrombosis. A CT or MRI is done to confirm the diagnosis. For further investigation, a CT scan may also be done on teeth and mouth.
One or all structures of the orbit may become inflamed due to an inflammatory disorder that affects only the eye or a disorder which affects the whole body. The inflammatory disorder in which general inflammation of blood vessels takes place is called vasculitis. This disorder includes granulomatosis with polyangiitis, previously known as Wegener granulomatosis.
Inflammatory disorders affecting only the eye include scleritis in which inflammation of the white portion of the eye takes place. Inflammation of the lacrimal gland is known as inflammatory dacryoadenitis. Inflammatory orbital pseudotumor is a type of inflammation of the entire orbit and it is not actually a tumor.
Symptoms of inflammation occur over a few days and include pain in the eyeball, redness abnormal bulging of the eyes etc. double vision and complete vision loss may also occur. The treatment is done by corticosteroid either administered intravenously or orally.
Tumors can appear in the orbit within the tissues or can reach the orbit after metastasizing from some other part of the body. The tumors can cause bulging eyeball as they push the eye from behind. Tumors can cause double vision, pain and vision loss. A CT scan and MRI are done to check for the size and location of the tumor and to ensure exclusion of other abnormalities. Usually, a tissue sample is taken for microscopic examination to determine the type of the tumor. The treatment includes surgery, chemotherapy and radiation therapy.
The cavernous sinus is a large vein located behind the eyes at base of the skull. This is a very rare disorder in which a blood clot is formed in this vein. This disorder is caused when the bacteria spreads from the facial infections or sinus infections. It can cause visual disturbances, bulging eyes, high fever and head and facial pain. CT scan and MRI of the eyes, brain and the nasal sinuses are done for diagnosis. The treatment is done with high potency antibiotics.
Diseases of the eye orbit are treatable and can be completely cured if diagnosed in time. Since the eye area is very delicate and complex, the treatment should be done by an ophthalmologist only. Any delay in the treatment may result in permanent vision loss. Therefore, any changes in the eye, even if minute, should be taken seriously and a doctor should be consulted.