Orbital cases

.....................	The most common orbital case and indeed in the fellowship examination is thyroid eye disease. Learn to use Hertel's exophthalmometer well without  making it look threatening to the patient ie. make sure the edges of the meter  are wide apart as you rest them on the orbital rims. Also remember to check  if the proptosis is axial or non-axial. Non-axial proptosis may imply space  occupying lesion outside the muscle cone.Apart from measuring the amount  of proptosis, do not forget to test the ocular motility and the optic nerve function.  Most common case by miles   thyroid eye disease Uncommon cases   carotico-cavernous fistula cavernous haemangioma Courzon's disease post-enucleation syndrome
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