Classification and Evaluation of Orbital Disorders in Children

Abstract

The classification of orbital disorders can be done by either clinical presentation or by pathologic evaluation. It is important to recognize that the incidence of specific conditions is quite different depending on which method is utilized. In the present chapter, a number of large studies are presented that are examples of each method of classification. It is important for the reader to recognize this in reviewing each study. Regardless of the method, however, certain principles still apply in regard to clinical evaluation, including history, physical examination, and, importantly, the noninvasive neuro-ophthalmic localization of disease. This is, of course, aided by various methods of neuroimaging, of which magnetic resonance has assumed prominence for all intracranial or intracanalicular processes. Computed tomography (CT) still has benefits for studying bony abnormalities. While faster and less expensive than MRI, however, the risk of ionizing radiation has more recently become of greater concern, and a reduced radiation dose is now recommended as well as seeking to limit exposure to the orbits when evaluation of the brain or the entire skull is deemed unnecessary.