What is orbital inflammatory disease (OID), and what rheumatic conditions are associated with it?
OID is a term which encompasses inflammation involving various structures in the orbital space outside of the globe, including the extraocular muscles, lacrimal gland, and orbital adipose tissue. Symptoms vary based on disease severity and the specific ocular structures involved but may include pain, orbital swelling, diplopia, chemosis, and proptosis. Severe forms of the disease may lead to optic nerve compression, and in some patients proptosis may alter the shape of the eye and increase risk of exposure keratopathy. GPA, sarcoidosis, and IgG4-related disease (IgG4-RD) are among the most common rheumatologic conditions associated with OID, and an evaluation for those conditions should be considered in patients presenting with OID. Less common rheumatologic causes of OID include SS (typically presenting with mild dacryoadenitis), IBD, Behçet’s disease, RA, SLE, adult-onset Still’s disease, amyloidosis, and histiocytic disorders.
