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Inflammation of the Orbit

(Inflammatory Orbital Pseudotumor)

By

James Garrity

, MD, Mayo Clinic College of Medicine and Science

Last full review/revision Aug 2021| Content last modified Aug 2021
Click here for the Professional Version

Any or all of the structures within the orbit may become inflamed because of a bodywide inflammatory disorder or an inflammatory disorder that affects only the eye.

People of all ages can be affected. Inflammation can be brief or long lasting and can recur.

Causes of Orbital Inflammation

Inflammation of the orbit can be the result of a bodywide (systemic) inflammatory disorder. Sometimes the inflammation affects only the eye.

Inflammatory disorders that affect only the eye include scleritis Scleritis Scleritis is severe, destructive inflammation of the sclera (the tough, white, fiber layer covering the eye) that may threaten vision. Scleritis sometimes occurs in people who have a bodywide... read more , in which the white coat of the eye (sclera) becomes inflamed. Eyelid disorders Eyelid and Tearing Disorders read more with inflammation are discussed elsewhere. Inflammation affecting any or all parts of the orbit is called inflammatory orbital pseudotumor (which is not really a tumor and is not a cancer) or nonspecific orbital inflammation. Inflammation affecting the tear (lacrimal) gland, located at the upper outer edge of the orbit (see figure Where Tears Come From Where Tears Come From Canaliculitis is inflammation (usually caused by infection) of the canaliculus. The canaliculus (plural, canaliculi) is a short channel near the inner corner of the eyelid through which tears... read more ), is called inflammatory dacryoadenitis. Inflammation affecting one of the muscles that move the eye is called myositis.

Symptoms of Orbital Inflammation

Symptoms vary depending on which structures are actually inflamed. In general, symptoms start rather suddenly, typically over a few days. Pain and redness of the eyeball or eyelid usually occur. Pain can be severe and incapacitating at times. Abnormal bulging of the eyes (proptosis Eyes, Bulging Bulging or protruding of one or both eyes is called proptosis or exophthalmos. Exophthalmos is usually used when describing bulging eyes caused by Graves disease, a disorder causing overactivity... read more Eyes, Bulging ), double vision, and vision loss are also possible. Symptoms related to IgG4-related orbital inflammation, on the other hand, are minimal. Rarely is there any discomfort, but rather proptosis and eyelid swelling Eyelid Swelling A person may experience swelling in one or both eyelids. Swelling may be painless or accompanied by itching or pain. Eyelid swelling is distinct from bulging eyes, although a few disorders can... read more are common.

Diagnosis of Orbital Inflammation

Treatment of Orbital Inflammation

  • Drugs to treat inflammation

  • Radiation therapy or drugs to change immune response

Many disorders causing inflammation of the orbit are treated with a corticosteroid drug, which can be given by mouth. Corticosteroids can be given by vein (intravenously) if the inflammation is severe. Radiation therapy or drugs and treatments that change the body’s immune responses may sometimes be used. IgG4 typically responds to corticosteroids or, if necessary, other drugs to change the body's immune response.

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Test your knowledge

Herpes Zoster Ophthalmicus
Herpes zoster ophthalmicus is an infection of the eye caused by the varicella-zoster virus. This virus also causes chicken pox and shingles. Which of the following describes the mechanism by which herpes zoster ophthalmicus causes infection?
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