Proptosis is the forward displacement of the eyeball due to a disease process within or adjacent to the orbit. The eyeball can be displaced in different directions due to the rigid walls of the orbit. Common causes of proptosis include neoplastic masses like rhabdomyosarcoma or optic glioma in children, vascular lesions such as venous varices or cavernous hemangiomas in adults, and inflammatory or infectious processes. Evaluation involves a detailed history, physical exam to assess eye displacement and vision, and imaging tests like CT or MRI. Management depends on the underlying cause and may include biopsy, chemotherapy for cancers, surgery to remove masses, or orbital decompression for conditions like Graves' disease.

1. Proptosis

2. Definition
Forward displacement of eyeball due to any
disease process within or adjacent to orbit as
consequences of rigid confines of orbital wall
Protruding eyeball may be displaced other
direction like medial, lateral, up or down
Pseudoproptosis;- protrusion doesn't originate
from a mass or inflammation or vascular disorder
Clinically significant proptosis:- displacement
2mm greater than other measured by krahn or
hertal exophthalmometer

3. CAUSES:
• Neoplastic-
• Rhabdomyosarcoma
• Optic glioma
• Ca-metastatic, 2° from adjacent brain|tissue etc
• Vascular:-
• Venous varix, cavernous hemangioma,carotid cavernous fistula
• Inflammation &infection:-
• Idiopathic, orbital cellulitis or abscess, mucormycosis etc.

5. Children
• Dermoid cyst
• Most common benign tumor
• Trapped ectoderm-suture lines during development
• Painless, progessive proptosis
• Ct show cyst with pressure effects
• Treat-surgical excision

7. Rhabdomyosarcoma
• Most common malignant tumor of orbit
• Painless but progressive can spread to adjoining
PNS
• Treatment: radiation and chemotherapy five yr
survival 90%

9. Cavernous
hemangioma
Most common benign tumor of
adults
18-67 yrs
Painless, progressive,unilat
proptosis
Ct/mri- round or oval mass
without ass inflammation or
infiltration
Encapsulated mass. Inraconal
Treatment :complete excision by
lat orbitectomy

10. Lymphoma

11. Evaluation
• Detailed history
• Associated illness
• Pain
• Visual loss
• Physical exam- type of displacement,condition of conjunctiva,
ocular movement,vision
• Check of pulsating or change in postion
• Ct/mri
• Usg
• Fnac
• Systemuc exams

12. Management
• Biopsy needed
• Ant lesion- lid or conjunctival incision
• Excsional biopsy-dermoid, cavernous hemangioma etc
• Medical management with antibiotics-cellulitis
• Chemo- lymphoma, radiation-malginancy
• Surgery- debulking of lymphangioma
• Endoscopic orbital decompression- graves exophthalmos
• Lat orbitectomy-lesion of lacrimal glands or inraconal
• Transcranial- lesion at orbital apex or invaded intracraniay from orbit
•