Proptosis

Changed by Ahmed Ali Abdel Hameed, 6 Jul 2014

Updates to Article Attributes

Body was changed:

Show markup changes

Proptosis refers to forward protrusion of the globe with respect to the orbit. There are many causes of proptosis which can be divided according to location - its worth remembering that its not just orbital disease processes that cause proptosis.

Proptosis vs exophthalmos

Exophthalmos also describes forward protrusion of the globe. Several authors use the terms differently, which is confusing:

proptosis and exophthalmos used interchangeably
exophthalmos used to refer to severe (over 18 mm) proptosis ⁵
exophthalmos used to refer to endocrine-related proptosis ⁶

Radiographic features

CT

Assessment of proptosis on cross-sectional imaging is difficult and dependant on the study being acquired in the correct plane:

the plane of the study must be parallel to the head of the optic nerve and the lens
the patient must have their eyes open and be looking forward with no eye movement

The reference line for measurement of proptosis is the interzygomatic line (a line is drawn at the anterior portions of the zygomatic arches):

the distance from this line to the posterior sclera is normally 9.9 +/- 1.7 mm ²
the distance from this line to the anterior surface of the globe should be less than 23 mm ⁴

The thickness of the intraocular muscles can also be used ¹.

proptosis
- proptosis (differential)
- proptosis (an approach)

-<p><strong>Proptosis</strong> refers to forward protrusion of the <a href="/articles/globe" title="globe">globe</a> with respect to the <a href="/articles/orbit" title="orbit">orbit</a>. There are many <a href="/articles/causes-of-proptosis" title="causes of proptosis">causes of proptosis</a> which can be divided according to location - its worth remembering that its not just orbital disease processes that cause proptosis.</p><h4>Proptosis vs exophthalmos</h4><p>Exophthalmos also describes forward protrusion of the globe. Several authors use the terms differently, which is confusing:</p><ul>
~~-<li>proptosis and exophthalmos used interchangeably</li>~~
+<p><strong>Proptosis</strong> refers to forward protrusion of the <a href="/articles/globe">globe</a> with respect to the <a href="/articles/orbit">orbit</a>. There are many <a href="/articles/causes-of-proptosis">causes of proptosis</a> which can be divided according to location - its worth remembering that its not just orbital disease processes that cause proptosis.</p><h4>Proptosis vs exophthalmos</h4><p>Exophthalmos also describes forward protrusion of the globe. Several authors use the terms differently, which is confusing:</p><ul>
+<li>proptosis and exophthalmos used interchangeably</li>
~~-</li>~~
+</li>
~~-</li>~~
+</li>
~~-<li>the plane of the study must be parallel to the head of the optic nerve and the lens</li>~~
~~-<li>the patient must have their eyes open and be looking forward with no eye movement</li>~~
-</ul><p>The reference line for measurement of proptosis is the <a href="/articles/interzygomatic-line" title="interzygomatic line">interzygomatic line</a> (a line is drawn at the anterior portions of the <a href="/articles/zygomatic-arches" title="zygomatic arches">zygomatic arches</a>):</p><ul>
+<li>the plane of the study must be parallel to the head of the optic nerve and the lens</li>
+<li>the patient must have their eyes open and be looking forward with no eye movement</li>
+</ul><p>The reference line for measurement of proptosis is the <a href="/articles/interzygomatic-line">interzygomatic line</a> (a line is drawn at the anterior portions of the <a href="/articles/zygomatic-arches">zygomatic arches</a>):</p><ul>
~~-</li>~~
+</li>
~~-</li>~~
~~-</ul><p>The thickness of the <a href="/articles/intraocular-muscles" title="intraocular muscles">intraocular muscles</a> can also be used <sup>1</sup>.</p><h4>Related articles</h4><ul><li>~~
+</li>
+</ul><p>The thickness of the <a href="/articles/intraocular-muscles">intraocular muscles</a> can also be used <sup>1</sup>.</p><h4>Related articles</h4><ul><li>
~~-<li><a href="/articles/proptosis-differential" title="proptosis (differential)">proptosis (differential)</a></li>~~
~~-<li><a href="/articles/proptosis-an-approach" title="proptosis (an approach)">proptosis (an approach)</a></li>~~
+<li><a href="/articles/proptosis-differential">proptosis (differential)</a></li>
+<li><a href="/articles/proptosis-an-approach">proptosis (an approach)</a></li>

ADVERTISEMENT: Supporters see fewer/no ads

{"current_user":null,"inclusions":[{"imageId":2733119,"studyId":20770,"caseSlug":"bilateral-ocular-proptosis","caption":"Case 1: hyperthyroidism","thumbnail":"https://prod-images-static.radiopaedia.org/images/2733119/83c4174e8a0a13cb4c196178eac3b2_big_gallery.jpg","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated"},{"imageId":2597111,"studyId":20336,"caseSlug":"sphenoid-wing-meningioma","caption":"Case 2: sphenoid wing meningioma","thumbnail":"https://prod-images-static.radiopaedia.org/images/2597111/4a8123f347cbb0649d5202cd20b631_big_gallery.jpg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":15532,"studyId":6818,"caseSlug":"orbital-venous-malformation","caption":"Case 3: orbital venous malformation","thumbnail":"https://prod-images-static.radiopaedia.org/images/15532/024bf7b3bffb8cf8629772926471aa_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated"},{"imageId":2111194,"studyId":18372,"caseSlug":"thyroid-orbitopathy-1","caption":"Case 4: thyroid orbitopathy","thumbnail":"https://prod-images-static.radiopaedia.org/images/2111194/4fc23e6b31e30fb161e06f4cf2c94f_big_gallery.jpg","isStack":true,"diagnosticCertainty":"probable"},{"imageId":51900505,"studyId":84056,"caseSlug":"optic-nerve-sheath-meningioma-12","caption":"Case 5: optic nerve meningioma","thumbnail":"https://prod-images-static.radiopaedia.org/images/51900505/a5614710dd1a12b727dcb100632f98_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"confirmed_unsubstantiated"},{"imageId":55600150,"studyId":109624,"caseSlug":"mucocele-of-the-ethmoidal-sinus","caption":"Case 6: ethmoidal mucocele","thumbnail":"https://prod-images-static.radiopaedia.org/images/55600150/6._big_gallery.jpeg","isStack":true,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":63509022,"studyId":141558,"caseSlug":"traumatic-optic-nerve-avulsion","caption":"Case 6: trauma","thumbnail":"https://prod-images-static.radiopaedia.org/images/63509022/b4ef2231d80f7674ab5027bf23c3e1a59a00bfada0dad1c2d65cfa84bee9710a_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"confirmed_unsubstantiated"}],"ddx_inclusions":[],"lang":"us"}