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Trochleitis is inflammation of the superior oblique tendon trochlea apparatus characterized by localized swelling, tenderness, and severe pain. This condition is an uncommon but treatable cause of periorbital pain. The trochlea is a ring-like apparatus of cartilage through which passes the tendon of the superior oblique muscle.
The sensation of pain has been described by patients as "burning eyes", "terrible, unrelenting pain", a feeling of "a knife in my eye" or "paper cuts". [5] The pain is usually described as being located in and around the eye, but can progress to the surrounding areas of the face and head. A signature characteristic of ocular neuropathic pain is ...
Patients presenting with a headache originating at the posterior skull base should be evaluated for ON. This condition typically presents as a paroxysmal, lancinating or stabbing pain lasting from seconds to minutes, and therefore a continuous, aching pain likely indicates a different diagnosis. Bilateral symptoms are present in one-third of cases.
Other symptoms include headache, fatigue, aching in the teeth, pressure or pain in the ears, and mucus dripping down the back of the throat (or postnasal drainage), per the Mayo Clinic.
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Orbital cellulitis is inflammation of eye tissues behind the orbital septum. It is most commonly caused by an acute spread of infection into the eye socket from either the adjacent sinuses or through the blood. It may also occur after trauma. When it affects the rear of the eye, it is known as retro-orbital cellulitis.
Eye injury by impact of small plastic body. Based on the injury to the eyewall (outer fibrous coat of the eye consisting of cornea and sclera) Closed globe injury: the eye globe is intact, but the seven rings of the eye have been classically described as affected by blunt trauma. Types include contusion and lamellar laceration
To summarize, the actions of the superior oblique muscle are (1) depression of the eyeball, especially when the eye is adducted; and (2) intorsion of the eyeball, especially when the eye is abducted. The clinical consequences of weakness in the superior oblique (caused, for example, by fourth nerve palsies) are discussed below.