Advances in ophthalmic plastic and reconstructive surgery
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Adv Ophthalmic Plast Reconstr Surg · Jan 1987
ReviewAdvanced diagnostic imaging techniques in ophthalmology.
Diagnostic imaging techniques continue to gain tremendous importance in the evaluation of ocular and orbital disease as technical developments and refinements are made. This article presents key diagnostic imaging methods, with special focus directed toward the advanced modalities important in evaluation of the traumatized eye and orbit. ⋯ Each of the diagnostic modalities discussed is presented in terms of its basic biophysical mechanism, indications, and advantages and disadvantages. The techniques described include simple plain film roentgenography (and its contrast-related applications: dacryocystography, orbital venography, and angiography), axial hypocycloidal tomography, computed tomography, ultrasonography, and magnetic resonance imaging.
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Seemingly trivial adnexal injuries may be associated with extensive injuries to the globe, orbit, and brain. A meticulous ophthalmologic examination and orbital and brain computed tomography (CT) scans (axial and coronal views) are essential for complete evaluation of these patients. The ophthalmologist must remain an active participant in the management of these patients to preserve the integrity of the globe.
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Trauma to the orbit is evaluated with a careful history, a thorough physical examination, and specific radiographic studies. Orbital trauma involves a wide range of conditions, including soft tissue adnexal injury, orbital contusion, optic nerve damage, ocular injury, intraorbital foreign bodies, and orbital fractures. This article emphasizes the importance of an accurate history and a comprehensive examination. It highlights relevant questions to ask, discusses the meaning of pertinent complaints, describes steps in the examination, discusses the diagnostic importance of the physical findings, and recommends specific radiographic studies for accurate identification and localization of orbital fractures and intraorbital foreign bodies.