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Orbital pseudotumor

Idiopathic orbital inflammatory syndrome (IOIS)

 

Orbital pseudotumor is the swelling of tissue behind the eye in an area called the orbit. The orbit is the hollow space in the skull where the eye sits. The orbit protects the eyeball and the muscles and tissue that surround it. Orbital pseudotumor does not spread to other tissues or places in the body.

Causes

 

The cause is unknown. It mostly affects young women, although it can occur at any age.

 

Symptoms

 

Symptoms may include:

  • Pain in eye, and it may be severe
  • Restricted eye movement
  • Decreased vision
  • Double vision
  • Eye swelling (proptosis)
  • Red eye (rare)

 

 

The health care provider will examine your eye to look for signs of pseudotumor. You will also need to have tests to determine if you have:

  • Pseudotumor
  • A cancerous tumor
  • Other eye problems

Tests may include:

  • CT scan of the head
  • MRI of the head
  • Ultrasound of the head
  • Skull x-ray
  • Biopsy

 

Treatment

 

Mild cases may go away without treatment. More severe cases most often respond well to corticosteroid treatment. If the condition is very bad, the swelling may put pressure on the eyeball and damage it. Surgery may be needed to move the bones of the orbit to relieve the pressure.

 

Outlook (Prognosis)

 

Most cases are mild and outcomes are good. Severe cases may not respond well to treatment and there may be some loss of vision. Orbital pseudotumor most often involves only one eye.

 

Possible Complications

 

Severe cases of orbital pseudotumor may push the eye forward so much that the lids cannot cover and protect the cornea. This causes the eye to dry out. The cornea may become cloudy or develop a sore. Also, the eye muscles may not be able to properly aim the eye which can cause double vision.

 

When to Contact a Medical Professional

 

People with this condition need regular follow up care with an eye doctor who is familiar with the treatment of orbital disease.

Call your health care provider right away if you have any of the following problems:

  • Irritation of the cornea
  • Redness
  • Pain
  • Decreased vision

 

 

References

Goodlick TA, Kay MD, Glaser JS, Tse DT, Chang WJ. Orbital disease and neuro-ophthalmology. In: Tasman W, Jaeger EA, eds. Duane’s Ophthalmology. 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 2, chap 14.

Karesh JW, On AV, Hirschbein MJ. Noninfectious orbital inflammatory disease. In: Tasman W, Jaeger EA, eds. Duane’s Ophthalmology. 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 2, chap 35.

Yanoff M, Cameron D. Diseases of the visual system. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 431.

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      Tests for Orbital pseudotumor

       
         

        Review Date: 9/2/2014

        Reviewed By: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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