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1. Wegner granuloma is one of the vasculitis most often accompanied by orbital manifestations. It is a necrotizing granulomatous vasculitis with unknown causes, which is more common in 40 ~ 50 years old, and the ratio of male to female is 2: 1. It often involves eyes, joints, skin, heart and peripheral nerves. Orbital involvement occurred in 50% of patients with ocular manifestations, often bilateral orbital involvement at the same time, eyelid sarcoma, lacrimal adenitis and nasolacrimal passage could occur simultaneously, and more than 90% had paranasal sinus diseases. Serum neutrophil cytoplasmic antibody (ANCA) increased in 60% ~ 90% of patients. If the patient has exophthalmos, inflammatory infiltration of corneoscleral margin, respiratory tract, lung and kidney diseases, the diagnosis can be basically established.
2. Acute patients with idiopathic inflammatory pseudotumor dacryocystitis are characterized by pain in the upper temporal orbit, tenderness in the lateral upper eyelid, obvious edema and congestion, transverse S "shape in the upper eyelid with ptosis, redness and swelling of some lacrimal glands in the conjunctiva of the superior temporal fornix, edema and congestion in the lateral conjunctiva, pain, limited eye movement and diplopia caused by involvement of adjacent lateral rectus muscles, without systemic manifestations. Chronic patients can be secondary to acute type or chronic at the beginning, showing painless lacrimal fossa mass. CT shows that lacrimal gland is enlarged, the density is evenly increased, the surrounding tissues are partially infiltrated, and there is no bone destruction. After corticosteroid treatment, the symptoms are obviously relieved and the lesions are reduced.
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