Proptosis: Difference between revisions
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==Background== | ==Background== | ||
*Forward displacement of the eye | |||
*Can be bilateral as in Graves disease | |||
==Clinical Features== | ==Clinical Features== | ||
[[File:Proptosis 2014-10-28 12-32.jpg|thumb|Proptosis in a woman with retrobulbar [[abscess]] and orbital cellulitis]] | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
*[[Graves' disease]] (bilateral) | |||
*[[Cavernous sinus thrombosis]] | |||
*[[Carotid-cavernous fistula]] | |||
*[[Orbital cellulitis]] | |||
*[[Mucormycosis]] | |||
*[[Orbital fractures]] | |||
*[[Orbital hematoma]] | |||
{{Periorbital swelling DDX}} | |||
== | ==Evaluation== | ||
*Clinical exam ([[Eye Exam]]) | |||
**PERRL, EOMI, [[visual field testing|visual fields]] | |||
**Assess for [[diplopia]] | |||
**Visual acuity | |||
**Intraocular pressure measurement (see [[Tono-Pen use]]) | |||
*[[head CT|CT]] with maxillofacial cuts | |||
*Consider CTA or [[brain MRI|MRI]]/MRV | |||
==Management== | ==Management== | ||
*Management depends of pathophysiology | |||
*Increased IOP may require a lateral [[Canthotomy]] | |||
==See Also== | ==See Also== | ||
*[[Lateral Canthotomy]] | *[[Lateral Canthotomy]] | ||
*[[Globe luxation reduction]] | |||
== | ==References== | ||
<references/> | <references/> | ||
[[Category:Ophthalmology]] | |||
[[Category:Symptoms]] | |||
Latest revision as of 21:35, 26 September 2020
Background
- Forward displacement of the eye
- Can be bilateral as in Graves disease
Clinical Features
Proptosis in a woman with retrobulbar abscess and orbital cellulitis
Differential Diagnosis
- Graves' disease (bilateral)
- Cavernous sinus thrombosis
- Carotid-cavernous fistula
- Orbital cellulitis
- Mucormycosis
- Orbital fractures
- Orbital hematoma
Periorbital swelling
Proptosis
- Normal IOP
- Orbital cellulitis
- Orbital pseudotumor
- Orbital tumor
- Increased IOP
- Retrobulbar abscess
- Retrobulbar emphysema
- Retrobulbar hemorrhage
- Ocular compartment syndrome
- Orbital tumor
No proptosis
- Periorbital cellulitis/erysipelas
- Dacryocystitis (lacrimal duct)
- Dacryocele/Dacryocystocele
- Dacryostenosis
- Dacryoadenitis (lacrimal gland)
- Allergic reaction
- Nephrotic Syndrome (pediatrics)
Lid Complications
- Blepharitis (crusts)
- Chalazion (meibomian gland)
- Stye (hordeolum) (eyelash folicle)
Other
- Subperiosteal abscess
- Orbital abscess
- Cavernous sinus thrombosis
- Conjunctivitis
- Contact dermatitis
- Herpes zoster
- Herpes simplex
- Sarcoidosis
- Granulomatosis with polyangiitis
Evaluation
- Clinical exam (Eye Exam)
- PERRL, EOMI, visual fields
- Assess for diplopia
- Visual acuity
- Intraocular pressure measurement (see Tono-Pen use)
- CT with maxillofacial cuts
- Consider CTA or MRI/MRV
Management
- Management depends of pathophysiology
- Increased IOP may require a lateral Canthotomy