There is no agreement about how to manage fibrous dysplasia (FD) in the orbital region, especially when the disease affects the apex. In order to prevent visual loss, some authors recommend an early and radical resection while others indicate surgery only in the event of a clear deterioration of vision. In the present paper we report the ophthalmic results of a cross-sectional study of a large series of patients with orbital FD (24 patients, 38 orbits). To our knowledge, this is the largest series of orbital FD reported with full ophthalmic examination. Overall, the findings indicate that radiological evidence of apical involvement does not necessarily imply that neural compression is clinically manifest. Patients may continue to have normal visual function for a long time despite severe optic canal and superior orbital fissure involvement. Fibrous dysplasia (FD) is a bone disorder characterized by the occurrence of solitary or multifocal lesions composed of fibrous tissue with immature woven bone trabeculae. The true prevalence of FD is difficult to estimate but the disease is not considered to be rare. In the orthopaedic literature it is reported to represent 5% to 7% of begin bone tumors. When FD occurs in the craniofacial region, the orbits are commonly involved. Patients with orbital FD present with the classical signs of proptosis, dystopia and periorbital facial asymmetry. The purpose of the present paper is to report the ophthalmic findings of a large series of patients with orbital FD (n = 24 patients/38 orbits) including those with optic canal narrowing (12 patients/21 orbits)
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