Proptosis of the Eye (Exophthalmos)

CLINICAL DIAGNOSIS MANUAL

Proptosis, or exophthalmos, is the abnormal protrusion of one or both eyeballs. This clinical sign may indicate various underlying conditions affecting the orbit or related structures.

Pathology	Diagnosis of Suspicion	Diagnosis of Confirmation
Graves’ Ophthalmopathy	Proptosis, symptoms of hyperthyroidism (weight loss, tachycardia), irritated eyes.	Thyroid function tests showing elevated thyroid hormones and TSI antibodies.
Orbital Cellulitis	Sudden proptosis with pain, redness, fever, restricted eye movement.	CT or MRI of the orbits to identify inflammation, abscess; cultures to identify the infectious agent.
Carotid-Cavernous Fistula	Proptosis with audible bruit over the eye, conjunctival congestion, possible ocular pulse.	Angiography to demonstrate abnormal communication between the carotid artery and the cavernous sinus.
Orbital Tumours	Progressive proptosis, vision changes, pain depending on tumour location.	MRI or CT of the orbits to identify the mass; biopsy to determine the benign or malignant nature of the tumour.