Johns Hopkins School of Medicine, USA
Title: Update on management of orbital inflammation
McCulley currently serves as Vice Chair of Clinical Strategic Planning at the Wilmer Eye Institute, Johns Hopkins School of Medicine. In 1995 he obtained his medical degree at Washington University School of Medicine in St Louis. After a combined medical and surgical internship at the University of Hawaii, he completed residency in Ophthalmology at Stanford University in 1999. Following one year fellowship training in neuro-ophthalmology at The Bascom Palmer Eye Institute, he completed two years of fellowship training in ophthalmic plastic and reconstructive surgery at the Cincinnati Eye Institute in 2003.
When approaching a patient with an inflamed orbit, The most troubling aspect is often diagnosis. When no cause is identified, as a diagnosis of exclusion, we label patients with the term idiopathic orbital inflammatory syndrome (IOIS). On initial evaluation, a primary goal is to identify infectious and/or systemic disease. Often a thorough history can help guide further evaluation. Imaging is usually obtained urgently and can particularly useful in identifying infection. When initial evaluation is indicative of IOIS, rapid resolution follows immunosuppression, which is tailored to severity. In atypical, steroid resistant or recurrent cases serologic evaluation and biopsy may be indicated. In this talk, recent advances in imaging and management of patients presenting with an inflamed orbit will be discussed. Focus will also be placed on identifying patients with potentially sight threatening or fatal diseases which may present similarly to IOIS.