Neuro-ophthalmologic evaluation of the orbit

Diseases of the orbit present with typical orbital localizing findings including proptosis, lid findings (e.g., edema, retraction, ptosis), visual loss (e.g., optic neuropathy), external signs (e.g., palpable mass), or restrictive or paretic ophthalmoplegia. The clinician dealing with orbital disease should be aware, however, that neuro-ophthalmic disease can coexist with orbital disorders; that orbital findings may be the presenting signs of systemic or neurological conditions; and that certain key portions of the neuro-ophthalmic exam should be performed in selected cases of orbital disease. This chapter discusses the major neuro-ophthalmologic features of orbital disease and the common neuro-ophthalmic pathology of the orbit that may mimic tumors. The orbital tumors are not discussed in detail; instead a review of the tumors of the optic nerve with special emphasis on optic nerve glioma and meningioma is included.