Proptosis
- Forward displacement of eye (exophthalmos)
- Caused by orbital mass or inflammation, expansion of orbital bones, fistulas and thrombosis of cavernous sinus
- This patient had rhabdomyosarcoma, malignant tumor originating in orbit
- Periocular pain
- Reduced vision
- Prominent eye
- Digital pressure on eye may be met by abnormal resistance to retropulsion
- Hyperemic conjunctiva
- Retracted or ptotic lid
- Reduced eye movements
- Lid retraction as seen in hypervigilant states, including psychosis, BUT...looking at patient from side reveals that eye is not displaced forward
- Conjunctivitis, BUT...only conjunctiva is swollen; eye is not displaced forward
- Dacryocystitis, BUT...only lower nasal portion of lid is swollen; eye is not displaced forward
- Refer to ophthalmologist with urgency dependent on findings
- Imaging will be necessary for diagnosis
- Common causes of unilateral proptosis will turn out to be tumor, sino-orbital inflammation, and cavernous sinus fistula or thrombosis
- Common causes of bilateral proptosis will turn out to be Graves disease, sino-orbital inflammation, and cavernous sinus fistula or thrombosis
- Delayed diagnosis may be life-threatening