Globe Retraction Workup

Updated: Mar 15, 2016
  • Author: Michael T Yen, MD; Chief Editor: Andrew G Lee, MD  more...
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Workup

Approach Considerations

The following diagnostic tools may be used:

  • Orbital imaging (CT scanning or MRI)
  • Skull radiography may show the fracture, but CT scanning is superior.
  • Orbital ultrasonography for tumor or pseudotumor of orbit
  • Metastatic evaluation, if appropriate
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Laboratory Studies

Laboratory studies include the following:

  • Complete blood count - If surgery is contemplated

  • Electrolytes - If surgery is contemplated

  • Liver function studies - For possible liver metastasis

  • Carcinoembryonic antigen or CA-15-3 - If breast carcinoma is suspected

  • Prostrate specific antigen - If prostate carcinoma is suspected

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Imaging Studies

CT scanning or MRI of orbits consist of 3-mm cuts, axial and coronal views. CT is better for evaluating the bony structure. MRI is better for evaluating the orbital contents and soft tissues. Evaluate fractures. Assess potential extraocular muscle entrapment. These studies may reveal the presence of orbital mass.

Chest radiography is performed if lung nodules suggest lung carcinoma. It may identify any suspicious breast lesions.

CT scan of neck/thorax/abdomen may be used to evaluate for systemic malignancy.

B-scan ultrasonography may be performed upon any doubt of globe integrity.

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Procedures

Orbital biopsy is indicated when orbital mass is present and no known systemic malignancy is identified.

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Histologic Findings

Often in metastatic scirrhous tumors, needle biopsy can result in minimal or no tissue retrieval. If biopsy is required for identification of an orbital mass, open biopsy with microscopical and histochemical evaluation should be performed. This also allows for identification of specific hormonal receptors that may alter ultimate chemotherapeutic regimen.

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