Nonspecific orbital inflammation - External and Internal Eye
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Synopsis
NSOI is the third most common orbital inflammatory disease, followed by thyroid disease and lymphoproliferative disease. It can present unilaterally or bilaterally. Bilateral cases are more often seen in children. It can affect all ages and either sex, but there is a higher predominance in middle-aged patients and in female patients.
Patients will classically present with sudden-onset diffuse chemosis and orbital pain. They can also present with proptosis, diplopia, and visual changes. Rarely, NSOI can present as a focal mass or with optic nerve sheath swelling (perineuritis). CT / MRI and rarely orbital biopsy can aid in diagnosis. The treatment of choice is oral corticosteroids, but other options such as external beam radiotherapy, chemotherapeutic agents, or surgical decompression may be used.
Codes
ICD10CM:H05.10 – Unspecified chronic inflammatory disorders of orbit
SNOMEDCT:
72789009 – Inflammatory pseudotumor of orbit
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Orbital cellulitis
- Carotid-cavernous fistula
- Thyroid eye disease (see Graves ophthalmopathy)
- Sarcoidosis
- Granulomatosis with polyangiitis (formerly known as Wegener granulomatosis)
- Lymphoproliferative disease
- Metastatic disease (see metastatic tumors to the orbit)
Best Tests
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Management Pearls
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Therapy
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References
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Last Reviewed:02/06/2020
Last Updated:05/05/2020
Last Updated:05/05/2020