Orbit

It is an autoimmune disorder of the orbit that can accompany certain thyroid diseases (Graves' disease and Hashimoto's thyroiditis).

It results in various clinical signs:

exophthalmos (protrusion of the eye)
diplopia (double vision)
eyelid abnormalities (eyelid edema, eyelid retraction)
eye damage (red, painful and swollen eye)
in severe forms, there is a loss of vision (by compression of the optic nerve or corneal ulcers) which requires emergency treatment.

Additional tests
Dr. Bela will work closely with your attending physician and your endocrinologist to arrange a full diagnostic workup:

Ophthalmological assessment
Orthoptic assessment
MRI or Scanner
Blood test

Treatment

The treatment consists on the one hand of treating the thyroid. Your endocrinologist will set up different options:

medical treatment with synthetic antithyroid drugs or radioactive iodine
thyroid removal surgery

On the other hand, you will benefit from an ophthalmological treatment. This has two purposes:

protect your eye with lubricating eye drops and ointment.
reduce inflammation with intravenous infusions of corticosteroids.

After the thyroid disease has been treated, Dr. Bela will be able to treat the sequelae of the orbitopathy with reconstructive surgery.

treatment of proptosis by bone or fat decompression surgery
treatment of diplopia by surgery of strabismus and oculomotor muscles
treatment of eyelid retraction by eyelid lengthening surgery

These are inflammatory diseases of the tissues around the eye:

lacrimal gland (dacryoadenitis)
eye muscles (myositis)
intra orbital fat and eyelid (inflammatory orbitopathy)

It results in various clinical signs:

exophthalmos (protrusion of the eye)
diplopia (double vision)
eyelid abnormalities (eyelid edema, eyelid retraction)
eye damage (red, painful and swollen eye)
in severe forms, there is a loss of vision (by compression of the optic nerve or corneal ulcers) which requires emergency treatment.

When the cause is found, it is called a specific inflammatory syndrome. Sometimes the cause is unknown, it is then called a non-specific inflammatory syndrome.

Here are some examples of general diseases giving a specific inflammatory syndrome:

Vasculitis (Wegener, Churg-Strauss syndrome, Polyarteritis nodosa)
Granulomatous pathologies (Sarcoidosis, Tuberculosis)
IgG4 syndrome

Additional tests
These damages can be due to general diseases affecting other organs of the body. That's why Dr. Bela will work closely with your treating physician to arrange a full diagnostic workup.

Ophthalmological assessment
Orthoptic assessment
MRI or Scanner
Blood test
Sometimes a biopsy of diseased tissue in the operating room is necessary

Treatment
The treatments depend on the etiology and will be organized by your general practitioner as well as a specialist doctor if necessary.

Orbital tumors can affect any tissue in the orbit.

Their classification is very extensive. She depends:

affected structures
of their nature: benign or malignant.

Additional tests:
Diagnosis is most often made on imaging. Dr. Bela collaborates with a state-of-the-art radiology department specializing in orbital imaging to ensure the best quality of care. You will benefit from a complete assessment with:

MRI or Scanner
Ophthalmological assessment
Orthoptic assessment
Blood test
The diagnosis of certainty is made by analysis of the tissues under a microscope by a pathologist.

On a biopsy of diseased tissue in the operating room
On the complete surgical excision piece

Treatment
The management of orbital tumors will depend on the nature of the tumor.

Most often it is a surgical treatment.

Thanks to the collaboration with an anapathomopathologist doctor present in the operating room, the tumor can be biopsied in order to have the diagnosis of certainty immediately. Then Dr. Bela will perform a total excision of the tumor and you will benefit from an on-site verification to ensure that the excision limits are sound.

If the tumor is too large to be completely removed or there is a risk of recurrence, surgical treatment is sometimes combined with additional radiotherapy

Some tumors need to be treated with chemotherapy alone without surgery.