Defination: out ward bulging of eyeball

causes

unilateral proptosis

1. orbital cellulitis

2. hemorrhage

3. varicose veins

4. hemangioma

5. dermoid cyst

6. thyroid eye disease

bilateral proptosis

1. thyroid eye disease

2. cavernous sinus thrombosis

3. Idiopathic orbital  inflammatory disease

intermittent proptosis 

• vericose veins

pulsating proptosis:

pulsating with pulse: carotid cavernous fistule

not with pulse:: neurofibramatosis with sphenoid wing hypoplasia

pseudo proptosis

buphthalmos

high myopia

retraction of upper eye lid

shallow orbit as in craniofacial abnormality

clinical evaluation

history:

1. sudden or gradual

2. trauma

3. whooshing sound in head

4. pain 

5. thryoid dysfunction

Measurement of proptosis

By ruler

By hertels exophthalmometer

 other examination

1. Visual acuity

2. Pupil examination

3. Extraocular movements

4. Fundus examination

5. Auscultation

6. Valsalva menovour

Radiological examination

B-scan

Plain X-rays

CT scan

MRI

LAB investigaions

T3 T4 TSH

CBC ESR

Treatment

1. Exploratory operation and biopsy

2. Surgical excision

3. Benign tumors and dermoid

4. Anterior orbitotomy

5. Lateral orbitotomy

6. Transfrontal orbitotomy