Acute orbital pseudotumor: ocular emergency on a general medical service

We have reported a case of acute orbital pseudotumor, an idiopathic inflammatory process that usually responds dramatically to corticosteroids. Untreated, severe proptosis and eventual optic neuropathy may result. Although its signs and symptoms may cause confusion with infectious, endocrinologic, traumatic, allergic, and neoplastic ophthalmopathies, the acute onset, rapid progression, and characteristic CT picture are nearly pathognomonic of orbital pseudotumor. When both the clinical and CT findings are compatible with this diagnosis, a therapeutic trial of oral corticosteroids can be undertaken. It is important for the primary physician to be aware of this disease to facilitate appropriate diagnosis and treatment, avoiding unnecessary surgical intervention and possible complications.