眼眶病源性斜视误诊分析

目的探讨由眼眶病引起的斜视和复视的临床病例误诊原因,以提高临床诊治水平。方法分析作者自2004年1月到2004年12月在临床医疗中遇到的7例由眼眶病引起的斜视误诊典型病例。结果在眼眶病变中,甲状腺相关眼病、肌炎型眼眶特发性炎性假瘤、眼眶骨折、颈内动脉海绵窦瘘、鼻窦炎侵犯眼眶、眼眶肿瘤等均可引起斜视和复视。其中尤其是甲状腺相关眼病引起的斜视最常见,甲状腺功能正常的患者容易引起误诊。结论:后天性斜视中,眼眶病源性病变引起者临床上并不少见,值得临床医生重视。影像学检查对减少误诊有重要意义。

The misdiagnosis of strabismus originated from orbital diseases

Purpose: To analyze the misdiagnosis of strabismus caused by orbital diseases in order to improve the therapeutic outcome of these special type of strabismus. Methods: The typical clinical cases of strabismus originated from orbital diseases from January 2004 to December 2004 in our hospital were introduced in detail. Results: Many orbital diseases such as thyroid associated ophthalmopathy, idiopathic orbital inflammatory pseudotumor(the subtype of myositis), orbital fracture, carotid cavernous fisula, orbital extension of sinusitis, and orbital tumors could cause eye displacement and eye deviation.Thyroid associated ophthalmopathy is the most common one. Those with euthyroidism were often misdiagnosed in clinical practice. Conclusions: Acquired strabismus caused by orbital diseases is not as less common as we expected.Orbital imaging plays an important role in reducing misdiagnosis and mistreatment.