Proptosis
A comprehensive overview of proptosis, including causes, symptoms, diagnosis, treatment, and prognosis.
Orbital Disorder
Anterior displacement of the globe
Sign of underlying orbital disease
Often
Overview
Proptosis, also called exophthalmos, refers to abnormal forward displacement of the eye. It is a clinical sign rather than a diagnosis and may result from thyroid eye disease, orbital inflammation, infection, hemorrhage, vascular abnormalities, or orbital tumors. Acute painful proptosis is an ophthalmic emergency requiring urgent evaluation.
Symptoms & Signs
- Forward displacement of the eye
- Eyelid retraction or incomplete closure
- Diplopia
- Ocular pain or pressure
- Decreased vision
- Exposure keratopathy
- Restricted extraocular movements
Risk Factors & Associations
- Thyroid eye disease
- Orbital cellulitis
- Orbital tumors
- Orbital hemorrhage or trauma
- Carotid-cavernous fistula
- Idiopathic orbital inflammation
Diagnosis
- Comprehensive eye examination
- Pupil and optic nerve assessment
- Exophthalmometry
- Extraocular motility testing
- CT or MRI of the orbits
- Thyroid function tests when indicated
Differential Diagnosis
| Condition | Distinguishing Feature |
|---|---|
| Thyroid eye disease | Bilateral proptosis with lid retraction |
| Orbital cellulitis | Fever, pain, restricted motility |
| Orbital tumor | Progressive painless proptosis |
| Carotid-cavernous fistula | Pulsatile proptosis with conjunctival congestion |
Lid retraction.
Pain and fever.
Progressive mass.
Pulsatile eye.
Treatment
- Treat the underlying cause
- Urgent antibiotics for orbital cellulitis
- Corticosteroids for selected inflammatory disorders
- Orbital decompression when indicated
- Lubrication for exposure keratopathy
Complications & Prognosis
- Exposure keratopathy
- Optic neuropathy
- Permanent vision loss
- Outcome depends on the underlying etiology
Common ICD-10 Codes
| Code | Description |
|---|---|
| H05.20 | Unspecified exophthalmos |
| H05.89 | Other disorders of orbit |
| E05.00 | Thyrotoxicosis with diffuse goiter (associated) |
Exophthalmos
Other orbital disorder
Associated thyroid disease
Frequently Asked Questions
Is proptosis an emergency?
Acute or painful proptosis, especially when accompanied by vision loss, fever, or double vision, requires urgent medical evaluation.
What is the most common cause of adult proptosis?
Thyroid eye disease is the most common cause of bilateral adult proptosis.
Medical Disclaimer
The information provided on Kardia Vision is for educational purposes only and should not replace professional medical advice, diagnosis, or treatment. Sudden eye bulging, vision loss, severe pain, or double vision requires immediate medical evaluation.