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ARTICLES
Year : 1982  |  Volume : 30  |  Issue : 5  |  Page : 489-490

Clinical study of proptosis


Department of Ophthalmology, Guntur Medical College, Guntur, India

Correspondence Address:
K Prabhakra Rao
Deprt. of Ophthalmology, Gurntur Medical College, Guntur
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Rao K P, Rao K V, Rao M R, Rao B S. Clinical study of proptosis. Indian J Ophthalmol 1982;30:489-90

How to cite this URL:
Rao K P, Rao K V, Rao M R, Rao B S. Clinical study of proptosis. Indian J Ophthalmol [serial online] 1982 [cited 2020 Nov 27];30:489-90. Available from: https://www.ijo.in/text.asp?1982/30/5/489/29238

The aetiological diagnosis and management of proptosis is a challenge to ophthalmologist. The present study was conducted on 100 conse­cutive cases of proptosis seen in the Depart­ment of ophthalmology and Neuro Surgery of Guntur Medical College, Guntur during a period of 2½ years.


  Observations Top


In the present series retinoblastoma extend­ing into orbit causing proptosis was the com­monest tumour (21%) followed by Nasopharyn­geal tumours (12%). Inflammations accounted for a large number of cases in the present series (38%). This has not been mentioned in other series as probably inflammatory causes of proptosis were not taken into consideration. Tumours and mucoceles from paranasal sinuses account for 6%. Out of the metastatic tumours (7%) Ewings tumour account for 2%. Out of primary tumours (9%) 2 cases were hemangio­mas and lacrimal gland tumours were 3 cases. Meningiomas and optic nerve tumours were conspicuous by their absence in the present series. Cases were equally distributed between both sexes. Maximum incidence was noticed in 1st decade and this was due to Retinoblas­tomas in the present series (21 cases). Between 20 and 50 years there were 34 cases. Degree of proptosis ranged from 3 mm to 19 mm. Maximum proptosis of 19 mm. was noticed in a case of cavernous hemangioma of orbit. There were 12 cases of Bilateral proptosis and out of these 8 were retinoblastomas 2 cases of Leukemia with proptosis, one case of Adrenal Neuroblastoma and one case of cavernous sinus Thrombosis. There were 68 cases of axial proptosis, 16 cases showed downward displace­ment, 7 cases showed down and in proptosis, 8 cases up and in displacement and one case medial displacement. Most of the cases of inflammatory proptosis and retinoblastomas were axial type. Palpable mass was made out in 25 cases only. Ocular movements were restricted in 84 cases. Papilloedema was present in all primary tumours, 3 out of 7 matastatic tumours, in one case of cavernous sinus throm­bosis and in 4 cases of orbital cysts.

Visual failure was noticed in most of the cases of inflammatory proptosis. Primary and secondary tumours of orbit; 30 cases revealed radiological abnormalities. Among these 13 were retinoblastomas and the rest were lymp­homa, Nasopharyngeal tumours, Meibomian carcinoma, Mucoceles, Hydatid cyst and Hemangioma.

In the present study analysis of causative factors of proptosis revealed 38% were to be due to inflammation of orbit such as orbital abscess, periostitis of orbital margin and pseudo tumours. Secondary tumours account­ed for 42% of cases, out of these 21 cases were due to retinoblastoma. Nasopharyngeal tumours accounted for 12 cases, Meibomian carcinoma 3 cases, Tumours and Mucoceles from paranasal sinuses 6 cases. Metastatic tumours accounted for 7%. Out of these two cases were anaplastic carcinomas, one case of neuroblastoma 2 cases of Ewing's tumours and 2 cases of Leukaemias.


  Treatment Top


Treatment of proptosis is mainly surgical in orbital tumours. A number of approaches are available depending on the site of tumours. Anterior orbitotomy is useful for lesions ante­rior to equatorial plane where as deeper tum­ours especially in muscle cone, require lateral orbitotomy or transfrontal approach. In the present series 3 cases required lateral orbitoto­mies, two being angiomas, and one neurinoma in the muscle cone. Two cases were operated by transcranial approach. One case was hydatid cyst in the roof of orbit, and one case a lymphoma arising from frontal bone cxtend­ing into orbit. In our experience, Berke's modification of Kronlein's was found to be good.


  Summary Top


100 cases of proptosis are presented. The incidence clinical features and treatment are briefly reviewed.




 

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