Checklists for the Differential Diagnosis of Orbital Affections

Numerous diseases can present as orbital or periorbital swelling, i.e. an increase in the volume of the orbital contents or surrounding tissues with or without discoloration of the overlying skin. We have therefore developed a differential diagnostic checklist for clinical evaluation of the patient with orbital or periorbital swelling prior to further investigation. It is based on the history (acuteness of onset, pain, itching, temporal pattern, patient's age, previous illnesses, previous treatment) and the findings on inspection and palpation (location, consistency, redness, pulsation, pseudoproptosis). On account of the long list of differential diagnoses it is rarely possible to make a diagnosis on the basis of a single category alone. However, with an integrative approach which considers the problem from various different angles, it is often possible to arrive at a diagnosis or at least to narrow down the number of possible diagnoses significantly. Imaging procedures and other investigations can then ...