Clinical Profile and Etiological Spectrum of Unilateral Proptosis: A Cross-sectional Observational Study.
DOI:
https://doi.org/10.51168/zczqdv82Keywords:
unilateral proptosis, thyroid-associated orbitopathy, orbital neoplasm, orbital cellulitis, orbital hematomaAbstract
Background
Unilateral proptosis is an abnormal forward displacement of one globe and can arise from endocrine, inflammatory, vascular, traumatic, or neoplastic disorders. Because the orbit is a confined anatomical space, delayed recognition of the underlying lesion can result in irreversible visual impairment or life-threatening complications.
Objectives
To describe the demographic, clinical, ophthalmological, investigational, and etiological profile of patients presenting with unilateral proptosis
Methods
This cross-sectional observational study included 20 patients evaluated through the ophthalmology outpatient and inpatient services of a tertiary care hospital in eastern India from October 2015 to September 2016. Proptosis was measured with a Luedde exophthalmometer. Clinical examination, erythrocyte sedimentation rate, ear-nose-throat assessment, orbital ultrasonography, and computed tomography were undertaken as clinically indicated. Etiologies were classified as endocrine, neoplastic, inflammatory, vascular, or traumatic. Data were summarized descriptively.
Results
Half of the patients were aged 16–30 years, and 12 (60%) were male. The right eye was involved in 14 (70%) patients, and axial proptosis was observed in 13 (65%). All patients presented with visible protrusion of one eye; restricted extraocular movements occurred in 15 (75%), ocular pain in 8 (40%), and visual impairment in 5 (25%). Thyroid-associated orbitopathy and neoplastic lesions were the joint leading etiological groups, each accounting for 5 (25%) cases. Inflammatory causes accounted for 4 (20%), while vascular and traumatic causes each accounted for 3 (15%).
Conclusion
Unilateral proptosis showed a broad etiological spectrum, with endocrine and neoplastic conditions occurring most frequently. Careful ophthalmic examination supported by targeted orbital imaging is essential for localization, etiological diagnosis, and protection of vision.
Recommendations
Patients with unilateral proptosis should undergo prompt, structured evaluation that includes visual assessment, ocular motility testing, exophthalmometry, systemic screening, and orbital imaging guided by the clinical presentation.
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