Special laboratory studies such as markers for rheumatoid disease or thyroid dysfunction may also be helpful. The CT typically demonstrates diffuse anterior orbital inflammation next to the globe with scleral and choroidal thickening. Enlargement of the extraocular muscles may also be seen on either ultrasound or CT scan. After an imaging diagnosis is made, a biopsy may be necessary to rule out leukemia or lymphoma. The histopathology of orbital pseudotumor shows polymorphic lymphocytic and plasmacytic infiltrates with eosinophilia.
Corticosteroids are the mainstay of therapy.
Once started, the symptoms quickly resolve as they did in our case. In fact, the response to steroids is so pathognomonic, that the diagnosis is often made retrospectively based on the response. A poor response indicates the need for biopsy. Childhood orbital pseudotumor. A case of orbital pseudotumor masquerading as orbital cellulitis in a patient with proptosis and fever.