Orbital trauma is a common consequence of craniofacial injury with potential for permanent vision loss. Rapid, accurate imaging interpretation is essential for triage and surgical planning. Multidetector computed tomography is the primary modality, enabling detection of fracture patterns, globe injury, extraocular muscle entrapment, and vascular complications. This article offers a systematic approach to orbital trauma evaluation, emphasizing findings that require urgent intervention, such as globe rupture, retrobulbar hematoma, muscle entrapment with ischemia, and orbital apex involvement. Diagnostic pitfalls and indications for surgical consultation are also discussed.

Various modalities, including computed tomography (CT), MR imaging, and PET/CT, are used in the radiological assessment of the treated orbit. Understanding the different surgical procedures used for orbital and ocular adnexal tumors and the imaging characteristics of recurrent tumors after complex reconstructive procedures in the orbital region is critical. Knowledge of treatment complications, including infection, osteoradionecrosis, radiation necrosis, radiation-associated secondary sarcomas, and tumor recurrence, is also important. To assist the radiologist, this article highlights several common orbital surgical procedures and complications that may arise following treatment.

Orbital tumors are diverse and relatively rare. Imaging studies such as MR imaging, computed tomography (CT), PET/CT, and ultrasound are essential for narrowing the differential diagnosis before surgery. The specific surgical approach for orbital tumors depends on location of the mass, size, and proximity to important orbital structures. The authors advocate close collaboration between the neuroradiologist and the orbital surgical team through weekly or monthly teaching and planning conferences and collaborative investigations that can ultimately lead to new discoveries and more reliable diagnoses and outcomes for patients with newly diagnosed orbital malignancy.

The orbit is a complex anatomic space containing functionally important structures, including the eye, optic nerve, and extraocular muscles. Tumors of the orbit are notably varied in presentation and histologic type and can be challenging to identify, diagnose, and treat secondary to the functional importance of the eye and its surrounding structures. Multidisciplinary expertise from orbital surgeons, radiologists, oncologists, and pathologists is paramount in the timely and accurate management of orbital tumors. Fortunately, with the advancement of surgical approaches, radiation delivery, and targeted medical therapy, patient outcomes and quality of life continue to improve.

This article provides an imaging-focused overview of conditions affecting vision that localize to the central skull base. Both neoplastic and nonneoplastic processes may arise from the sphenoid bone, sella turcica, and adjacent structures, with potential involvement of critical neurovascular pathways. Because clinical presentations in this region often overlap, identifying distinguishing features on computed tomography and MR imaging is essential for accurate diagnosis. The discussion highlights key imaging findings of pathology affecting visual function arising within and around the central skull base.

This article provides a comprehensive imaging-based description of central nervous system diseases that impair vision, spanning infectious, inflammatory, neoplastic, vascular, metabolic, neurodegenerative, congenital, traumatic, and idiopathic etiologies. It integrates visual pathway anatomy with characteristic clinical and imaging findings, emphasizing lesion localization from the retina to the occipital cortex. Advanced neuroimaging techniques, particularly MRI and CT, are highlighted as essential tools for diagnosis, prognostication, and management. By correlating areas of structural pathology with visual field deficits and pupillary abnormalities, this study underscores the critical role of imaging in preserving visual function and guiding clinical care.

Pathology of the cavernous sinus encompasses a broad and heterogeneous group of conditions that reflect the complex anatomy and critical neurovascular contents of this region. Accurate diagnosis relies on careful integration of clinical presentation with high-resolution imaging that delineates lesion location, extent, and behavior relative to the cavernous sinus walls, cranial nerves, and internal carotid artery. While many disease entities share overlapping imaging and clinical features, recognition of key distinguishing characteristics allows meaningful narrowing of the differential diagnosis and guides appropriate management strategies.

This article highlights the range of pathology encountered in the intraconal space of the orbit including infectious, inflammatory, benign, and malignant conditions. Knowledge of the anatomy of the intraconal contents is crucial to understanding the appearance of each lesion. Key imaging patterns and important clinical considerations are provided to aid the imager in forming a helpful differential.

The lacrimal gland produces the aqueous component of the tear film, and its disease can cause dry eye, pain, proptosis, or diplopia. Lacrimal gland lesions are diverse: roughly half inflammatory, a quarter lymphoproliferative, and a quarter epithelial tumor, with substantial overlap in imaging features. Consequently, tissue sampling remains essential for accurate diagnosis and management. Conventional CT and MR imaging aid in diagnosis and define anatomic extent; correlating imaging with clinical history and examination is vital. Advanced MR techniques may offer tissue-specific information. The lacrimal sac and extra-orbital sites should also be considered in formulating differential diagnoses and treatment strategies.

Advancements in computed tomography and MR imaging have greatly improved the detection of ocular abnormalities, necessitating a systematic diagnostic approach. Understanding globe anatomy and recognizing imaging features of both traumatic and non-traumatic conditions are essential for accurate diagnosis and appropriate referral. Awareness of incidental findings, such as degenerative changes or implants, helps avoid unnecessary investigations. This article highlights common pathologic processes affecting the various anatomic layers of the globe, illustrated through case examples, and aims to familiarize readers with the imaging features of frequently encountered ocular diseases.

This detailed article explores imaging techniques, particularly MR imaging and computed tomography, to evaluate perineural tumor spread involving the orbit originating from cutaneous malignancies. It emphasizes critical radiologic findings, the clinical implications of early detection, and management strategies aimed at optimizing patient outcomes.

This article outlines orbital anatomy and imaging correlates for diagnosis and surgical planning. The bony orbit houses the globe, optic nerve, extraocular muscles, lacrimal apparatus, vessels, and fat, with communications to cavernous sinus and intracranial space through foramina. Bony walls include roof, floor, medial lamina papyracea, and lateral walls; periosteum forms a delimiting potential space. The globe comprises cornea, sclera, iris, lens with zonules, and anterior and posterior chambers, while the posterior segment contains the vitreous, choroid, retina, and optic nerve. Extraocular muscles originate at the annulus of Zinn; openings include the superior and inferior orbital fissures and optic canal.

Orbit is a complex and intricate structure composed of conical bony walls, globe, lacrimal apparatus, soft tissues, optic nerve and cranial nerves III to VI. High-resolution MRI delineates these delicate anatomical structures in orbit, and emerging radiologic techniques including cone beam CT and photon counting CT have shown potentials for added benefit in orbital imaging. Multiple different imaging modalities including US, CT, MRI, and PET play complementary roles; US excels in superficial structures; CT shines in bone assessment; MR offers better tissue characterization; PET can add biochemical metabolic information in addition to other anatomical imaging modalities.

The optic pathway, or visual system, conveys sensory information from the retina in the globe to the visual cortex in the occipital lobe. The globe is the primary visual sensory organ responsible for gathering and focusing light and sending electrical and neural signals to the rest of the visual pathway. In the posterior globe, the retina detects incoming light from the environment and converts it into electrical and neural signals that travel along the optic nerve to be processed by the brain for visual perception. Disruptions in the optic pathway and associated clinical signs provide diagnostic information about underlying diseases.