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EVALUATION OF PROPTOSIS

DEFINITION


PROPTOSIS-PASSIVE PROTRUSION OF THE GLOBE FROM SOCKET. EXOPHTHALMUS-AN ACTIVE OR DYNAMIC PROCESS CAUSING PROPTOSIS. LUXATION ( DISLOCATION) OF GLOBE

PSEUDO-PROPTOSIS

ENLARGED GLOBE RETRACTION OF LIDS


ABNORMALITIES OF THE ORBIT

EXOPHTHALMOS
 

DUE TO SYMPATHETIC STIMULATION ENDOCRINE DISEASE

BILATERAL PROPTOSIS THYROID EYE DISEASE

THYROID EYE DISEASE

PROPTOSIS
  

  

PHYSIOLOGICAL PROPTOSIS ACUTE PROPTOSIS INTERMITENT OR TRANSITORY PROPTOSIS PULSATING PROPTOSIS UNILATERAL PROPTOSIS BILATERAL PROPTOSIS

INTERMITENT PROPTOSIS
      

ORBITAL VARICES (90%) VASCULAR ORBITAL NEOPLASMS RECURRENT ORBITAL HEAMORRHAGE VENOUS CONGESTION PERIODIC ORBITAL EDEMA RECURRENT EMPHYSEMA INTERMITENT ETHMOIDITIS

PULSATING PROPTOSIS


VASCULAR PULSATIONS(A)ANEURYSMS OF CAROTID OR OPHTHALMIC ARTERY : 1.A-V ANEURYSM (COMMONEST LESION) a) in the cavernous sinus (90%) b) in the orbit c) in the neck 2.SACCULAR ANEURYSMS (B)VENOUS DILATATIONS; THROMBOSIS

PULSATING PROPTOSIS


CEREBRAL PULSATIONSBECAUSE OF DEFECTIVE ORBITAL WALL (A) CONGENITAL (B)TRAUMATIC (C)EROSION OF ORBITAL WALL

UNILATERAL PROPTOSIS
      

CRANIAL DEFORMITIES (RARE) INFLAMMATORY CIRCULATORY DISTURBANCE CYSTS AND TUMOURS IN ASSOCIATION WITH GENERAL DISEASE TRAUMATIC LACK OF SUPPORT

ORBITAL CELLULITIS

ETHMOIDAL MUCOCELE

MAXILLARY CARCINOMA

UNILATERAL PROPTOSIS


INFLAMMATORY LESIONS (A)ACUTE INFLAMMATORY LESIONS (B)CHRONIC INFLAMMATORY LESIONS 1.RESEMBLING A TUMOUR WITHOUT INVOLVING SINUS FORMATION 2.WITH CHRONIC SINUS FORMATION AND DISCHARGE

UNILATERAL PROPTOSIS


CIRCULATING DISTURBANCES1.EDEMA 2.RETRO BULBAR HEAMORRHAGE 3.VARICOCELE 4.ANEURYSMS

UNILATERAL PROPTOSIS
   

CYSTS AND TUMOUR IN GENERAL DSEASE TRAUMATIC LACK OF SUPPORT

DERMOID CYST

PLEOMORPHIC ADENOMA OF ORBITAL PART OF LACRIMAL GLAND

PLEXIFORM NEUROFIBROMATOSIS

BILATERAL PROPTOSIS
      

DEVELOPMENTAL ANOMALIES OF SKULL OSTEOPATHIES CEPHALOCELES EDEMA INFLAMMATIONS NEOPLASMS SYSTEMIC DISEASE

CROUZON SYNDROME

APERT SYNDROME

SHALLOW ORBIT ROBERT SYNDROME

SHALLOW ORBIT ROBERT SYNDROME

THYROID EYE DISEASE

AGE-CHILDHOOD
        

MAL-FORMATIONS CHORISTOMAS HAMARTOMAS PRIMARY NEOPLASMS SECONDARY TUMOURS METASTATIC TUMOURS LEUKAMIAS AND LYMPHOMAS HISTIOCYTOSES AND XANTHOGRANULOMAS INFLAMMATIONS

CAPILLARY HAEMANGIOMA WITH SUBCUTANEOUS STRAWBERRY NEAVUS

CAPILLARY HAEMANGIOMA

CAPILLARY HAEMANGIOMASHOWING ENLARGEMENT IN SAME PATIENT

POSTERIOR ORBITAL ENCEPHALOCELE?NF-1

RAPIDLY EXPANDING ORBITAL MASSES IN CHILDREN


          

RHABDOMYOSARCOMA OTHER PRIMARY SARCOMA NEUROBLASTOMA METASTATIC LESIONS MYELOID SARCOMA BURKITTS LYMPHOMA EOSINOPHILLIC GRANULOMA CAPILLARY HAEMANGIOMA;LYMPHANGIOMA TRAUMATIC HEAMATOMA CYSTS- DERMOID,ANEURYSMAL BONE CYST INFLAMMATORY PSEUDOTUMOUR CELLULITIS/ABSCESS

METASTATIC NEUROBLASTOMA

EXAMINATION OF A CASE OF PROPTOSIS


       

AGE SEX HISTORY GENERAL PHYSICAL EXAMINATION SYSTEMIC EXAMINATION OCULAR EXAMINATION INVESTIGATIONS MANAGEMENT

AGE
       

AT BIRTH, NEONATAL PERIOD UP TO 1 YEAR 1-5 YEARS 5-10 YEARS 10-30 YEARS 30-50 YEARS 50-70 YEARS .>70 YEARS

SEX
 

DISEASES COMMON IN MALE DISEASES COMMON IN FEMALE

HISTORY
        

SYMPTOMS ONSET DURATION VARIATION SENSORY MOTOR PSYCHOPHYSICAL STRUCTURAL VASCULAR

PAST HISTORY ; FAMILY HISTORY AND GENERAL PHYSICAL EXAMINATION


    

INFECTIONS ENDOCRINE DISEASE IMMUNOLOGICAL DISEASE NEOPLASTIC DISEASE SURGERY AND TRAUMA

OCULAR EXAMINATION
     

INSPECTION PALPATION REDUCIBILITY PULSATION TRANSILLUMINATION INDUCING PROPTOSIS

ORBITAL VARICES BEFORE AND AFTER VALSALVA MANUEVER

ORBITAL VARICES BEFORE AND AFTER VALSALVA MANUEVER

UNILATERAL ENLARGED GLOBE

UNILATERAL ENLARGED GLOBE

OCULAR EXAMINATION
      

EYELIDS AND ADNEXA CONJUNCTIVA CORNEA ANTERIOR CHAMBER IRIS PUPIL LENS

EYELID ECCHYMOSIS
NEUROBLASTOMA EWINGS SARCOMA LEUKEMIA EOSINOPHILLIC GRANULOMA LYMPHANGIOMA ANEURYSMAL BONE CYST TRAUMATIC HAEMATOMA

LID ECCHYMOSISRHABDOMYOSARCOMA

CONJUNCTIVAL AND EPISCLERAL INJECTION

OCULAR EXAMINATION


  

EXTRA OCULAR MOVEMENTS a] versions and ductions b] hierSchbergs test c] forced duction test VISION- ASTIGMATISM; HYPERMETROPIA TENSION- PRIMARY GAZE ; SUPERIOR GAZE .SAC NLD BLOCK

MEASUREMENTS


  

DISPLACEMENT a] vertical b] horizontal BALLOTMENT EXOPHTHALMOMETRYLACRIMAL GLAND PALPATION

AXIAL PROPTOSIS- OPTIC NERVE GLIOMA

EXOPHTHALMOMETRY
 

DEFINITION TYPES 1. ZEHENDER 2. GORMAZ 3. LUEDDES 4. HERTELS 5. DAVANGERS 6. RADIOGRAPHIC 7. TOPOMETER OF WATSON 8. PERSPEX RULER

ZEHENDER EXOPHTHALMOMETER

DAVANGER EXOPHTHALMOMETER

LUEDDES EXOPHTHALMOMETER

HERTELS EXOPHTHALMOMETER

TOPOMETER OF WATSON

PERSPEX RULER

FUNDUS EXAMINATION
   

VITREOUS RETINA DISC CHOROID

CHORIO- RETINAL FOLDS

OPTICOCILIARY SHUNTS

INVESTIGATIONS
      

X-RAYS USG CT-SCAN MRI BIOPSY FNAC ORBITAL ANGIOGRAPHY; VENOGRAPHY