Orbital pseudotumor may present in different ways depending on its time course and the extent of orbital involvement.


Time course:

(1) acute - sudden onset over 1-2 weeks

(2) subacute

(3) chronic - insidious onset over weeks or months


Clinical features:

(1) ocular pain, often exacerbated by eye movements

(2) edema of the eyelids

(3) conjunctival chemosis and injection

(4) diplopia

(5) decreased vision

(6) optic neuropathy (visual field defects, disc edema)

(7) ptosis (drooping of the upper eyelid)

(8) proptosis or exophthalmos

(9) decreased ocular mobility

(10) decreased orbital resilience on ballottement

(11) general malaise

(12) afebrile

(13) palpable mass


Most patients respond promptly to high dose oral corticosteroid therapy.


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