Differentials
Orbital pseudotumor (idiopathic orbital inflammation)
SIGNS / SYMPTOMS
Patient may present with orbital symptoms (diplopia, decreased vision, ophthalmoplegia) and inflammatory signs: pain and chemosis. No signs of infection.
INVESTIGATIONS
CT scan will show a soft tissue enlargement (e.g. enlarged lacrimal gland or extraocular muscle) and fat stranding.
Thyroid eye disease
SIGNS / SYMPTOMS
Patient may present with features of hyperthyroidism. Eye symptoms manifest or worsen after radioactive iodine treatment; proptosis, lid lag sign (von Graefe sign), eyelid retraction, dysmotility.
INVESTIGATIONS
Orbital imaging will show enlarged extraocular muscles.
Panophthalmitis
SIGNS / SYMPTOMS
Patient may present with acute severe pain and decreased vision following intraocular surgery or foreign body; inflammed eye with hypopyon consistent with endophthalmitis.
INVESTIGATIONS
Microbiologic testing of the vitreous reveals infection.
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