Orbits, Vision, and Visual Loss

American Journal of Neuroradiology

Clinical Condition: Orbits, Vision and Visual Loss

	MR Imaging Head and/or Orbit Without and With Contrast	MR Imaging Head and/or Orbit, Without Contrast	CT Head and/or Orbit With Contrast	CT Head and/or Orbit Without Contrast	MRA Head and Neck With or Without Contrast	CTA Head and Neck	X-ray Orbit
Infant or child with orbital asymmetry, proptosis and visual loss	8	7	6	5	4^{^a}	2^{^b}	1
Child with slowly progressing visual loss	8	7	6	5	4^{^a}	2^{^b}	1
Adult with sudden onset of painless or painful visual loss	8	7	6	5	5^{^a}	5^{^b}	1
Adult patient with proptosis and/or painful visual loss	8	7	6	5	4^{^a}	4^{^b}	1
Adult patient with uveitis, scleritis, and visual loss	8	7	5	4	4^{^a}	4^{^b}	1
Adult patient with ophthalmoplegia	9	6	6	5	6^{^a}	6^{^b}	1
Head injury with visual loss	5^{^d}	7^{^d}	3	9^{^c}	4^{^a}	4^{^b}	2

Note:—Appropriateness criteria scale from 1 to 9, 1 = least appropriate, 9 = most appropriate.
^a Selected cases when vascular disease is suspected. See statement regarding contrast in text under “Anticipated Exceptions.”
^b If vascular disease suspected.
^c In acute trauma, a scan without contrast is usually sufficient; in subacute trauma, contrast may be useful.
^d If MR imaging safe.