Instructions

1. You will be divided into groups of 14-15 students per group.

2. Answer the questions according to the case you are assigned to.
3. Write your answers in power point form. You will be given 20 minutes
to prepare your power point.
4. 4 groups will be picked randomly to present their answers in class.

Tip: Refer to slide “Orbits in Ophthalmology” slide to help answer these

questions.
Case #1
Patient presents to the clinic with both eyes appearing enlarged since 2
months ago. No visual impairment was complained. However, the
patient has difficulty gazing to the left. Patient also presents with loss
of weight, palpitations and diarrhea. The patient actively smokes.
Questions
• From the photo in the previous slide, what are the signs Presented in this
patient?
• From the history taking and physical examination, what do you suspect this
patient has?
• You decide to order an orbital CT scan for this patient, what can be seen
from his CT scan?
• From the case above, what is the disease activity of the patient?
• Explain the classification used to describe severity of this disease
• What is the severity grade of this patient?
• How would you treat this patient?
Case #2
Patient presents with painful, red and edematous left upper and
lower eyelid 1 day prior to presentation. The patient complains pain
in gazing. Fever (+). The patient has a history of untreated sinusitis
and dental caries.
Questions
• From the photo in the previous slide, what are the signs Presented in
this patient?
• From the history taking and physical examination, what do you
suspect this patient has?
• What are the etiologies of this disease?
• What are the complications of this disease?
• How would you manage this patient?
• What antibiotics would you suggest?
Case #3
Patient presents to the clinic with left eye appearing larger than usual
accompanied with redness of the eyelids and pain when gazing. Fever
(-), caries (-), trauma (-), sinusitis (-), surgery (-), palpitations (-),
weight loss (-).
Questions
• From the photo in the previous slide, what are the signs Presented in this
patient?
• You decide to order an orbital CT scan for this patient. What can be seen
from this CT scan?
• What is your most likely diagnosis?
• What other diseases is assosciated with this disease?
• Describe the management of this disease?
• If you were to perform a biopsy, what is your expected histopathologic
finding?
Case #4
A 2 year old patient presents to the ophthalmology clinic due
misalignment of the eye. When her parent took a photo of her, her left
pupil appeared white.
Questions
• From the photo in the previous slide, what are the signs Presented in this
patient?
• As a general physician, what other tool do you need to diagnose this
patient? What is your expected result?
• What is your most likely diagnosis?
• Describe the mutation that occurs in this disease?
• What is the difference between inherited and sporadic retinoblastoma?
• Describe the Treatment of this disease?
• What is the difference between enucleation, evisceration and
exenteration?