An Aetio-Epidemiological Inquiry of Proptosis

Abstract

Introduction: The protrusion of eyeball from its normal position within the rigid orbital cavity due to differingpathologies locally or systematically results in a condition called proptosis. The incidence, causes, presentationwith respect to direction, laterality, age and gender shows numerous differences. And so this study was aimedat inquiring the aetio-epidemiological basis of proptosis.Materials and Methods:Cases reported to department of ophthalmology at a tertiary care setup for a period of9 months with a provisional diagnosis of proptosis were clinically, opthalmologically examined and evaluated.The confirmed cases of proptosis were further studied for aetiology and detailed epidemiology.Results:Among the reported cases 50 were confirmed to be cases of proptosis. The male: female ratio was 2.5:1.Unilateral proptosis and eccentrically oriented proptosis were observed in maximum number of cases studied.The age distribution showed clustering around >40 years range. The main causative factor for proptosis wasobserved to be neoplasm followed on by inflammation in this study.Conclusion:Neoplasm as the primary aetiology warrants multi modal, multi-disciplinary approach ininvestigation and management of these cases of proptosis.KEY WORDS: Proptosis, Aetiology, Epidemiology, Exophthalmos, orbit.The rigid non-expansile bony orbit with itscontents forms a prominent feature of thehuman face. The eyeball with its coverings,muscles, vessels and nervous extension hasbony walls limiting them on both sides andposteriorly, while a fibrous orbital septum formsthe anterior limit. The communication of orbitalcontents and the surrounding regions is bysuperior and inferior orbital foramen and opticcanal [1]. Proptosis is the clinical manifestationof pathology that results in anterior displacementof the eyeball beyond the orbital margin [2,3].Due to the unyielding nature of the bony wallsof the orbit, any pathology that diminishes thespace within the bony orbit results in proptosis.Studies have shown widely varying incidence,age distribution and gender ratio of proptosis invarious populations from differing geographicalareas [4-6]. Proptosis can be bilateral orunilateral. Local pathology usually results inunilateral proptosis, whereas bilateral proptosisis often a manifestation of systemic disease