Proptosis : A clinical study conducted in Coimbatore Medical College

Amudha Vadivu, S (2007) Proptosis : A clinical study conducted in Coimbatore Medical College. Masters thesis, Coimbatore Medical College, Coimbatore.


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INTRODUCTION: Proptosis or exophthalmos is defined as protrusion of the globe beyond the orbital margins, with the patient looking straight ahead. Proptosis often refers to unilateral displacement of an eye and exophthalmos to bilateral displacement1. Henderson2 reserves the use of word exophthalmos for those cases of Proptosis secondary to endocrinological function. Proptosis is the common presenting symptom of wide variety of diseases affecting the structure present in and around the orbit. The orbits are a pair of bony cavities of the skull situated on either side. The fact that the orbit is in intimate relationship with the cranial cavity, the nose the paranasal sinuses around it makes it vulnerable to many disorders that might involve the orbit. A lesion in the intraconal region produces axial Proptosis and lesions in the extraconal region produces eccentric Proptosis. AIM OF THE STUDY: 1. Incidence of Proptosis among the general ophthalmic cases. 2. Aetiolgies of Proptosis in various age groups. 3. Most common cause of Proptosis. 4. Modalities of investigations and their role in diagnosis and treatment. 5. The best treatment options available and their respective out comes. MATERIALS AND METHODS: The study was conducted at Coimbatore Medical College Hospital(CMCH), Coimbatore between June 2004 and August 2006. Of which 50 patients presenting with Proptosis of the age ranging from eight (8) years to seventy (70) years were taken up for this study. Patients Evaluation : All patients were evaluated as follows. A detailed history of present and past illness was inquired. A thorough ocular examination was performed as follows : Inclusion Criteria : The patients who had proptosis both axial and eccentric, defective vision, nasal obstruction, Epistaxis, Extra ocular muscle movement restriction, Facial swelling, nasal mass, septal deviation, eye congestion, nasolacrimal sac pathology, lacrimal gland swelling were included and followed up. Exclusion Criteria Patients who had refractive error, cataract, papillitis, Corneal pathology glaucoma were excluded. SUMMARY: Fifty patients with proptosis who attended the OutPatient department of CMCH between June, 2004 – September,2006 were taken up for the study. The analysis included the various causes, incidence, mode of onset, sex, age of presentation, modalities of investigation and treatment. CONCLUSION: This study brings to light the fact that Propotosis accounts for 3.14% of general ophthalmic cases with a definite male prepondrance. Majority of the cases were unilateral and eccentric. Based on the data collected, it is arrived at the conclusion that the nasal obstruction and epistaxis are the commonest presenting E.N.T complains in cases of Proptosis of E.N.T origin. Nasal mass and facial swelling are the commonest finding in these cases. CA Maxilla and CA nasopharynx are the commonest causative lesions. Thus the majority of the lesions are neo plastic in origin. The second commonest cause in our hospital is Pseudo tumor orbit with the preponderance of male and unilaterality. Of the investigative modalities USG ( B scan) played a major role in diagnosis of soft tissue lesions and CT in diagnosis of bony lesion and intra cranial extension. Majority of the cases with Proptosis due to E.N.T cause thyroid exophthalmopathy present to the Ophthalmologist first and thus the Ophthalmologist plays a pivotal role in diagnosing and managing these cases in collaboration with ENT surgeon, plastic surgeon, radiologist and neurologist.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Proptosis; exophthalmos
Subjects: MEDICAL > Ophthalmology
Depositing User: Devi S
Date Deposited: 19 Oct 2017 11:19
Last Modified: 19 Oct 2017 11:19

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