NOT true regarding Orbital Pseudotumor?

• A. Primarily affects young to middle age children
• B. It affects the EOMs but not the muscle tendons
• C. It is idiopathic inflammatory condition
• D. It can be diagnosed with a CT/MRI

Answer: (B)

Orbital pseudotumor is an idiopathic inflammatory process that can involve multiple orbital tissues, not just the muscle bellies. A key point is that inflammation can affect the extraocular muscles together with their tendons (the muscle-tendon unit), so the idea that it affects the muscles but spares the tendons isn’t accurate. Imaging with CT or MRI often shows involvement of the EOMs and can extend to adjacent structures like fat or the lacrimal gland, helping distinguish it from other conditions such as thyroid eye disease, which tends to spare the tendons. Clinically, it presents with acute onset proptosis, pain, and often restricted eye movements, and it typically responds well to corticosteroids. The other statements are more consistent with typical features: it more commonly affects adults rather than young children; it is idiopathic and inflammatory; and CT/MRI can aid in diagnosis.