There is primary sinonasal, bone or skull base rather than a primary orbital disease process that might be causative and producing the patient’s signs and/or symptoms related to the orbit.   [Yes/No]

The pre-septal soft tissues including the lacrimal sac are abnormal.   [Yes/No]

The lacrimal gland is abnormal.   [Yes/No]

The bones and bony margins of the orbit including all component parts of the sphenoid bone are abnormal.   [Yes/No]

There is a structural abnormality or infiltrating process of the extraconal or intraconal compartments of the orbit.   [Yes/No]

The extraocular muscles appear to be swollen or otherwise abnormal.   [Yes/No]

The orbital apex and superior orbital fissure are infiltrated, edematous or otherwise abnormal.   [Yes/No]

There is enlargement and/or thrombosis of the superior, inferior or other orbital veins.   [Yes/No]

There is evidence of cavernous sinus thrombosis and/or inflammatory morphologic features in the cavernous sinus or para-cavernous region.   [Yes/No]

Proptosis is present.   [Yes/No]

The optic nerve is stretched in appearance.   [Yes/No]

The posterior aspect of the globe is tented in appearance.   [Yes/No]

Signs of tension orbit are present.   [Yes/No]

The uveal and scleral components of the globe are swollen or enhancing abnormally.   [Yes/No]

There is a hemorrhage or other abnormality causing a detachment of the choroid, hyaloid membrane and/or retina.   [Yes/No]

The optic disc region is abnormally swollen or enhancing.   [Yes/No]

The vitreous body is abnormal in appearance.   [Yes/No]

The anterior segment structures including the lens are abnormal in appearance.   [Yes/No]

Signs of endophthalmitis are present.   [Yes/No]

The optic nerves and/or optic sheaths appear abnormal in size.   [Yes/No]

The optic nerves appear otherwise abnormal.   [Yes/No]

There is abnormal enhancement of the optic nerves and/or of the optic sheath.   [Yes/No]

There is a structural abnormality or infiltrating process (especially around the optic sheath) of the intraconal compartment of the orbit.   [Yes/No]

There is a compressive lesion or infiltrative process present anywhere along the course of the optic nerves, optic chiasm or optic tracts before entering the brain.   [Yes/No]

There is a compressive lesion or infiltrative process present in the cavernous sinus or para-cavernous area.   [Yes/No]

There is evidence of an aneurysm or carotid cavernous fistula present.   [Yes/No]

There is abnormal meningeal or other enhancement of the optic chiasm, optic nerves or other structures in the suprasellar and/or chiasmatic cistern.   [Yes/No]

There is generalized abnormal meningeal enhancement.   [Yes/No]

There are intra-axial or extra-axial abnormalities of the brain that might be related to the orbital pathology.   [Yes/No]

There is evidence of obstructive or communicating hydrocephalus.   [Yes/No]