Proptosis

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

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

See Also

• Lateral Canthotomy
• Globe luxation reduction