Some Causes of Proptosis
Cause | Suggestive Findings | Diagnostic Approach |
|---|---|---|
Eye symptoms: Eye pain, lacrimation, dry eyes, irritation, photophobia, ocular muscle weakness causing diplopia, vision loss caused by optic nerve compression Systemic symptoms: Palpitations, anxiety, increased appetite, weight loss, insomnia, goiter, pretibial myxedema (see Hyperthyroidism) | Thyroid function tests Sometimes CT or MRI of orbits | |
Carotid-cavernous sinus or dural-cavernous sinus fistula | Pulsating proptosis with an orbital bruit | Magnetic resonance angiography |
Ophthalmoplegia, headache, ptosis, decreased visual acuity, fever | CT or MRI of brain and orbits | |
Tearing, blepharospasm, redness | Intraocular pressure measurement and fundoscopy by ophthalmologist | |
Redness, fever, pain, impaired visual acuity, impaired or painful extraocular movements Usually unilateral | CT or MRI of orbits | |
Orbital tumors (eg, lymphoma, hemangioma, vascular malformations) | Decreased visual acuity, diplopia, pain | MRI or CT or orbits |
Retrobulbar hemorrhage, orbital compartment syndrome | Decreased visual acuity, diplopia, pain, ophthalmoplegia, risk factors | Immediate CT orbits or treatment based on clinical findings |
Spheno-orbital meningioma | Pain, headache, visual field defects, ophthalmoplegia | MRI or CT of skull base |