Brief presentation on Proptosis

1. By Kevin Joseph Ambadan
*

2. *
Forward displacement of eyeball
beyond the orbital margins.
Exophthalmos is synonymous, but
used for the displacement associated
with thyroid d/s.

3. *
*U/l proptosis
*Bilateral proptosis
*A/c proptosis
*Intermittent proptosis
*Pulsating proptosis

4. *
*Unilateral Proptosis
• Congenital: dermoid cyst
congenital cystic eyeball
orbital teratoma
• Traumatic: orbital hemorrhage
retained intraorbital FB
traumatic aneurysm
emphysema of orbit

5. • Inflammatory Lesions:
A/c: orbital cellulitis
abscess
panophthalmitis
thrombophlebitis
cavernous sinus thrombosis
C/c: pseudotumours
tuberculoma
gumma
sarcoidosis

6. • Circulatory Disturbances & Vascular Lesions:
angioneurotic edema
orbital varix
aneurysms
• Cysts of orbit:
hematic cyst
implantation cyst
parasitic cyst (hydatid cyst & cysticercus cellulosae)
• Tumors:
primary, secondary or metastatic
• Mucocele of PNS:
frontal(most common), ethmoidal, maxillary sinuses

7. *Bilateral Proptosis
• Developmental Anomalies of Skull:
craniofacial dysostosis (oxycephaly(tower skull))
• Osteopathies:
osteitis deformans
rickets
acromegaly
• Inflammatory Conditions:
Mikulicz’s syndrome
late stage of cavernous sinus
thrombosis

8. • Endocrinal Exophthalmos:
thyrotoxic or thyrotropic.
• Tumors:
symmetrical lymphoma or lymphosarcoma
secondaries from neuroblastoma
Ewing’s sarcoma
leukemic infiltration
• Systemic Disease:
histiocytosis
systemic amyloidosis
Wegener’s granulomatosis.

9. *Acute Proptosis
Develops with extremely sudden onset.
•Common Causes
orbital emphysema
fracture of medial orbital wall
orbital hemorrhage
rupture of ethmoidal mucocele

10. *Intermittent Proptosis
Appears & disappears on its own.
•Common Causes:
periodic orbital edema
orbital varix
recurrent orbital hemorrhage
highly vascular tumors

11. *Pulsating Proptosis
•Causes:
1. Pulsating vascular lesions
(caroticocavernous fistula and saccular aneurysm
of ophthalmic artery)
2. Transmitted cerebral pulsations
associated with deficient orbital roof
(congenital meningocele or meningoencephalocele,
neurofibromatosis, traumatic or operative hiatus)

12. *