Downloaded 264 times
Uploaded byAbdullatif Al-Rashed
Differential Diagnosis of Proptosis
The document discusses the differential diagnosis of proptosis, detailing its causes, symptoms, and treatments. It highlights conditions such as Graves' disease, orbital cellulitis, and hemangiomas, emphasizing the importance of proper diagnosis and management strategies including medication and surgical options. Proptosis can result from various factors, and understanding these can help in providing appropriate care.
More Related Content
Similar to Differential Diagnosis of Proptosis
More from Abdullatif Al-Rashed
Differential Diagnosis of Proptosis
- 1. Differential Diagnosis of Proptosis AbdullatiffSami Al-Rashed Movement Block 4.4 (Opthalmology Week) 212516770 College of Medicine, King Faisal University Al-Ahsa, Saudi Arabia
- 2. Introduction • Proptosis, orexophthalmos, is a protrusion of the eye caused by a space occupying lesion. • Can be either bilateral or unilateral. • Measurement of the degree of exophthalmos is performed using an exophthalmometer.
- 3. Exophthalmometer A difference ofprominence of more than 2 mm between the two eyes is significant.
- 10.
- 11. Introduction • Autoimmune disorderwith orbital involvement and associated with thyroid dysfunction. • Women are affected more than men. • Proptosis could be unilateral or bilateral
- 12.
- 13. Eyelid Signs inGraves Disease Dalrymple sign: Upper eyelid is retracted with visible sclera superior to the limbus and widened palpebral fissure with developing exposure keratitis (overactive muscle of Müller)
- 14. Eyelid Signs inGraves Disease Gifford sign: Upper eyelid is difficult to evert (due to eyelid edema)
- 15. Eyelid Signs inGraves Disease Von Graefe sign: Upper eyelid retracts when the eye depresses (overactive muscle of Müller)
- 16. Eyelid Signs inGraves Disease Stellwag Sign (Rare blinking)
- 17. Eyelid Signs inGraves Disease Kocher sign ( Fixed Gaze )
- 18.
- 19. Treatment • Methylcellulose orhypromellose eyedrops: – To aid lubrication and improve comfort. • Systemic steroids (prednisolone 30–120 mg daily): – usually reduce inflammation if more severe symptoms are present. • Surgical decompression of the orbit: – Particularly if pressure of orbital contents on the optic nerve threatens vision. • Lid surgery: – Protect the cornea if lids cannot be closed.
- 20.
- 21. Introduction • Acute inflammationof the contents of the orbital cavity with the cardianl symptoms of limited motility and general malaise. • Orbital cellulitis is the most frequent cause of exophthalmos in children.
- 22.
- 23.
- 24. Investigations Test Results CBC Leukocytosis ESRIncreased Blood culture To detect specific organisms Nasal swap For gram stain CT scan orbit MRI For orbital abscess and evaluating for cavernous sinus disease
- 25. Complications Optic neuritis Cavernoussinus thrombosis
- 26. Treatment • High-dose intravenousantibiotic therapy: – Infants are treated with ceftriaxone and school-age children with oxacillin combined with cefuroxime in the appropriate doses. • Treatment of underlying sinusitis – Indicated in applicable cases.
- 27.
- 28. Hemangioma • Hemangiomas arethe most common benign orbital tumors in both children and adults. • They usually occur in a nasal superior location. • Capillary hemangiomas are more common in children (they swell when the child screams) • Cavernous hemangiomas are more common in adults.
- 30. Hemangioma • Treatment isonly indicated where the tumor threatens to occlude the visual axis with resulting amblyopia or where there is a risk of compressive optic neuropathy. • Capillary hemangiomas in children can be treated with cortisone or low-dose radiation therapy.
- 31. Other causes ofproptosis
- 33.