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Dr. Ankit Mahesh Punjabi Kota Eye Hospital, Kota, Rajasthan INDIA Email: [email protected] PROPTOSIS

Proptosis

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Proptosis is a common finding in orbital diseases. It can be due to congenital, inflammatory, infectious, neoplastic and miscellaneous disorders.

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Page 1: Proptosis

Dr. Ankit Mahesh PunjabiKota Eye Hospital,

Kota, RajasthanINDIA

Email: [email protected]

PROPTOSIS

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PLEOMORPHIC L G ADENOMAPRE.:- painless, firm, non-tender

CT scanTre.:- surgery

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MALIGNANT LG TUMOURFast growing PainfulCT scan Tt.:- radiotherapy, surgery.

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RHABDOMYOSARCOMAMost common primary malignant

orbital tumour in children.The four main histological type :-

1. Embryonal 3. Botyroid 2. Alveolar 4. Pleomorphic

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CLINICAL FEATURESPresentation:- first decade of life with a

rapidly progressive proptosis. Examination:- diagnosis is conformed by

biopsy.Systemic investigations:-CT of the chest,

abdomen & pelvis, liver function test,bone marrow biopsy, and skeletal radiographs.

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RHABDOMYOSARCOMA

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TREATMENT Radiotherapy:-Chemotherapy:-Exenteration:-

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DERMOID CYSTA benign cystic teratoma :-The two main types:- 1. Superficial 2 . Deep

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SUPERFICIAL DER0MOID CYST

Located anterior to the orbital septum.Presentation:-infancy, firm, round,

attachment to suture.Treatment is based on cosmetic

indications.

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DEEP DERMOID CYST Located posterior to the orbital septum.

Presentation:-adolescence, proptosis.

Treatment:-excision.

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BLOOD CYST Relatively rare:- May be associated with blunt trauma, lymphangioma, venous anomalies and blood dyscrasia.

Presentation:- progressive, non- tender proptosis.

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MUCOCELEFrontal EthmoidPresentation:- diplopia, proptopsis.

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MACOCELE OF LEFT FORNTAL SINUS

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OPTIC NERVE GLIOMAA slow-growing tumour.Affect in adults.Presentation:- visual loss first , proptosis.Examination:-disc oedema , atrophy.

CT scan, fusiform enlargement of ONTreatment:-

1. Observation. 3. Surgical 2. Radiotherapy

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MENINGIOMAOptic nerve sheathRare Middle aged womenPre.:- slowly progressive, U L ,visual loss.Examination:- ocular movement restriction

proptosis, disc oedema, atrophy. CT scan - tubular thickning of ON

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TREATMENTOBSERVATION RADIOTHERAPY EXCISION

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METASTATICChildren Neuroblastoma Ewing sarcoma Acute myeloid leukaemia

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ACUTE MYELOID LEUKAEMIA

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METASTATICAdult Breast Bronchus Prostate GIT

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TREATMENTRadiotherapy HormonalChemotherapySurgery

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ADJACENT STRUCTURESMaxillary ca.Ethmoidal ca.

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N P

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PRESEPTAL CELLULITIS

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ORBITAL CELLULITIS

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CAPILLARY HAEMANGIOMA

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CAPILLARY HAEMANGIOMA

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BILATERAL ORBITAL INVOLVEMENT BY LYMPHOMA

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Thank You