Recognizing globe tethering on CT
CT is especially useful for characterizing the posterior globe contour, measuring the posterior globe angle, and identifying the underlying cause of orbital mass effect.
Recommended CT review checklist
- Confirm proptosis and compare side-to-side.
- Assess posterior globe contour for a conical/tented shape.
- Measure the posterior globe angle when tenting is suspected.
- Evaluate optic nerve stretching and orbital apex crowding.
- Identify the cause: abscess, hemorrhage, vascular lesion, tumor/cyst, etc.
Reporting tips
- State whether globe tenting/tethering is present.
- Include the measured posterior globe angle (if feasible).
- Describe associated findings: proptosis degree, optic nerve tension, intraorbital lesion characteristics.
- Flag urgency when severe tenting is present (e.g., <120° with acute presentation).
Common pitfalls
Ensure the measurement plane is consistent, avoid obliquity, and interpret tenting in the context of clinical acuity and the full orbital findings.
Note: This site is for education and does not replace clinical judgement. If acute proptosis or vision loss is suspected, seek urgent specialist care.
