Proptosis - Revision history

Danbot: Strip excess bold

2026-03-22T09:36:06Z

Strip excess bold

← Revisión anterior		Revisión del 09:36 22 mar 2026
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	*In the ED, the key concern is distinguishing emergent causes requiring immediate intervention from non-emergent etiologies		*In the ED, the key concern is distinguishing emergent causes requiring immediate intervention from non-emergent etiologies
	*'''Unilateral acute proptosis''' with pain, vision loss, or elevated IOP is an emergency — consider retrobulbar hemorrhage, orbital cellulitis, or cavernous sinus thrombosis		*'''Unilateral acute proptosis''' with pain, vision loss, or elevated IOP is an emergency — consider retrobulbar hemorrhage, orbital cellulitis, or cavernous sinus thrombosis
	*~~'''~~Bilateral proptosis~~'''~~ is most commonly [[Graves' disease]]		*Bilateral proptosis is most commonly [[Graves' disease]]
	*Retrobulbar hemorrhage with elevated IOP requires emergent [[lateral canthotomy]]		*Retrobulbar hemorrhage with elevated IOP requires emergent [[lateral canthotomy]]

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	==Differential Diagnosis==		==Differential Diagnosis==
	===Emergent===		===Emergent===
	*~~'''~~Retrobulbar hemorrhage~~'''~~ (post-traumatic or post-surgical)		*Retrobulbar hemorrhage (post-traumatic or post-surgical)
	*~~'''~~[[Orbital cellulitis]]~~'''~~ (frequently from adjacent sinusitis)		*[[Orbital cellulitis]] (frequently from adjacent sinusitis)
	*~~'''~~[[Cavernous sinus thrombosis]]~~'''~~ (bilateral cranial nerve palsies, septic appearance)		*[[Cavernous sinus thrombosis]] (bilateral cranial nerve palsies, septic appearance)
	*~~'''~~[[Mucormycosis]]~~'''~~ (immunocompromised, diabetic ketoacidosis)		*[[Mucormycosis]] (immunocompromised, diabetic ketoacidosis)

	===Urgent===		===Urgent===
	*~~'''~~[[Carotid-cavernous fistula]]~~'''~~ (pulsatile proptosis, orbital bruit, chemosis)		*[[Carotid-cavernous fistula]] (pulsatile proptosis, orbital bruit, chemosis)
	*~~'''~~Orbital abscess~~'''~~ (complication of orbital cellulitis)		*Orbital abscess (complication of orbital cellulitis)
	*~~'''~~Orbital hematoma~~'''~~ (trauma)		*Orbital hematoma (trauma)

	===Subacute/Chronic===		===Subacute/Chronic===
	*~~'''~~[[Graves' disease]]~~'''~~ (most common cause of bilateral proptosis; can be unilateral)		*[[Graves' disease]] (most common cause of bilateral proptosis; can be unilateral)
	*Orbital tumors (lymphoma, rhabdomyosarcoma in children, meningioma, metastases)		*Orbital tumors (lymphoma, rhabdomyosarcoma in children, meningioma, metastases)
	*Orbital pseudotumor (idiopathic orbital inflammation)		*Orbital pseudotumor (idiopathic orbital inflammation)
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	===Imaging===		===Imaging===
	*~~'''~~CT orbits with contrast~~'''~~ (and maxillofacial cuts): primary imaging modality		*CT orbits with contrast (and maxillofacial cuts): primary imaging modality
	**Evaluates for retrobulbar hemorrhage, orbital abscess, sinusitis, fracture, foreign body, mass		**Evaluates for retrobulbar hemorrhage, orbital abscess, sinusitis, fracture, foreign body, mass
	**CT angiography if vascular cause suspected (carotid-cavernous fistula)		**CT angiography if vascular cause suspected (carotid-cavernous fistula)
	*~~'''~~MRI/MRV~~'''~~: better for cavernous sinus thrombosis, tumor characterization, optic nerve evaluation (non-emergent)		*MRI/MRV: better for cavernous sinus thrombosis, tumor characterization, optic nerve evaluation (non-emergent)

	===Laboratory===		===Laboratory===

Danbot: Expanded with EM-focused content: retrobulbar hemorrhage identification, canthotomy indication, red flags, evaluation, management by etiology, disposition

2026-03-20T23:35:23Z

Expanded with EM-focused content: retrobulbar hemorrhage identification, canthotomy indication, red flags, evaluation, management by etiology, disposition

Show changes

Rossdonaldson1: /* Differential Diagnosis */

2020-09-26T21:35:48Z

Differential Diagnosis

← Revisión anterior		Revisión del 21:35 26 sep 2020
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	*[[Orbital hematoma]]		*[[Orbital hematoma]]

	{{Periorbital swelling ~~images~~}}		{{Periorbital swelling DDX}}

	==Evaluation==		==Evaluation==

Rossdonaldson1: /* Differential Diagnosis */

2020-09-26T21:35:21Z

Differential Diagnosis

← Revisión anterior		Revisión del 21:35 26 sep 2020
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	*[[Orbital fractures]]		*[[Orbital fractures]]
	*[[Orbital hematoma]]		*[[Orbital hematoma]]

			{{Periorbital swelling images}}

	==Evaluation==		==Evaluation==

Rossdonaldson1 at 21:33, 26 September 2020

2020-09-26T21:33:38Z

← Revisión anterior		Revisión del 21:33 26 sep 2020
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	==Background==		==Background==
	~~[[File:Proptosis 2014-10-28 12-32.jpg\|thumb\|Proptosis in a woman with retrobulbar [[abscess]] and orbital cellulitis]]~~
	*Forward displacement of the eye		*Forward displacement of the eye
	*Can be bilateral as in Graves disease		*Can be bilateral as in Graves disease

			==Clinical Features==
			[[File:Proptosis 2014-10-28 12-32.jpg\|thumb\|Proptosis in a woman with retrobulbar [[abscess]] and orbital cellulitis]]

	==Differential Diagnosis==		==Differential Diagnosis==

ClaireLewis at 20:14, 22 October 2019

2019-10-22T20:14:24Z

← Revisión anterior		Revisión del 20:14 22 oct 2019
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	==Evaluation==		==Evaluation==
	*Clinical exam ([[Eye Exam]])		*Clinical exam ([[Eye Exam]])
	**PERRL, EOMI, visual fields		**PERRL, EOMI, [[visual field testing\|visual fields]]
	**Assess for diplopia		**Assess for [[diplopia]]
	**Visual acuity		**Visual acuity
	**Intraocular pressure measurement (see [[Tono-Pen use]])		**Intraocular pressure measurement (see [[Tono-Pen use]])

ClaireLewis: /* See Also */

2019-10-09T16:18:12Z

ClaireLewis at 01:00, 2 October 2019

2019-10-02T01:00:33Z

← Revisión anterior		Revisión del 01:00 2 oct 2019
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	*[[Graves' disease]] (bilateral)		*[[Graves' disease]] (bilateral)
	*[[Cavernous sinus thrombosis]]		*[[Cavernous sinus thrombosis]]
	*~~Cavernous sinus~~ fistula		*[[Carotid-cavernous fistula]]
	*[[Orbital cellulitis]]		*[[Orbital cellulitis]]
	*[[Mucormycosis]]		*[[Mucormycosis]]
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	**Visual acuity		**Visual acuity
	**Intraocular pressure measurement (see [[Tono-Pen use]])		**Intraocular pressure measurement (see [[Tono-Pen use]])
	*CT with maxillofacial cuts		*[[head CT\|CT]] with maxillofacial cuts
	*Consider CTA or MRI/MRV		*Consider CTA or [[brain MRI\|MRI]]/MRV

	==Management==		==Management==
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	[[Category:Ophthalmology]]		[[Category:Ophthalmology]]
			[[Category:Symptoms]]

Ostermayer: Text replacement - "abscess " to "abscess "

2017-03-10T09:56:33Z

Text replacement - "abscess " to "abscess "

← Revisión anterior		Revisión del 09:56 10 mar 2017
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	==Background==		==Background==
	[[File:Proptosis 2014-10-28 12-32.jpg\|thumb\|Proptosis in a woman with retrobulbar abscess and orbital cellulitis]]		[[File:Proptosis 2014-10-28 12-32.jpg\|thumb\|Proptosis in a woman with retrobulbar [[abscess]] and orbital cellulitis]]
	*Forward displacement of the eye		*Forward displacement of the eye
	*Can be bilateral as in Graves disease		*Can be bilateral as in Graves disease

Neil.m.young at 17:34, 26 July 2016

2016-07-26T17:34:40Z

← Revisión anterior		Revisión del 17:34 26 jul 2016
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	*[[Orbital hematoma]]		*[[Orbital hematoma]]

	==~~Workup~~==		==Evaluation==
	*Clinical exam ([[Eye Exam]])		*Clinical exam ([[Eye Exam]])
	**PERRL, EOMI, visual fields		**PERRL, EOMI, visual fields

← Revisión anterior		Revisión del 16:18 9 oct 2019
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	==See Also==		==See Also==
	*[[Lateral Canthotomy]]		*[[Lateral Canthotomy]]
			*[[Globe luxation reduction]]

	==References==		==References==