Proptosis

Dr. Ankit Mahesh PunjabiKota Eye Hospital,

Kota, RajasthanINDIA

Email: [email protected]

PROPTOSIS

PLEOMORPHIC L G ADENOMAPRE.:- painless, firm, non-tender

CT scanTre.:- surgery

MALIGNANT LG TUMOURFast growing PainfulCT scan Tt.:- radiotherapy, surgery.

RHABDOMYOSARCOMAMost common primary malignant

orbital tumour in children.The four main histological type :-

1. Embryonal 3. Botyroid 2. Alveolar 4. Pleomorphic

CLINICAL FEATURESPresentation:- first decade of life with a

rapidly progressive proptosis. Examination:- diagnosis is conformed by

biopsy.Systemic investigations:-CT of the chest,

abdomen & pelvis, liver function test,bone marrow biopsy, and skeletal radiographs.

RHABDOMYOSARCOMA

TREATMENT Radiotherapy:-Chemotherapy:-Exenteration:-

DERMOID CYSTA benign cystic teratoma :-The two main types:- 1. Superficial 2 . Deep

SUPERFICIAL DER0MOID CYST

Located anterior to the orbital septum.Presentation:-infancy, firm, round,

attachment to suture.Treatment is based on cosmetic

indications.

DEEP DERMOID CYST Located posterior to the orbital septum.

Presentation:-adolescence, proptosis.

Treatment:-excision.

BLOOD CYST Relatively rare:- May be associated with blunt trauma, lymphangioma, venous anomalies and blood dyscrasia.

Presentation:- progressive, non- tender proptosis.

MUCOCELEFrontal EthmoidPresentation:- diplopia, proptopsis.

MACOCELE OF LEFT FORNTAL SINUS

OPTIC NERVE GLIOMAA slow-growing tumour.Affect in adults.Presentation:- visual loss first , proptosis.Examination:-disc oedema , atrophy.

CT scan, fusiform enlargement of ONTreatment:-

1. Observation. 3. Surgical 2. Radiotherapy

MENINGIOMAOptic nerve sheathRare Middle aged womenPre.:- slowly progressive, U L ,visual loss.Examination:- ocular movement restriction

proptosis, disc oedema, atrophy. CT scan - tubular thickning of ON

TREATMENTOBSERVATION RADIOTHERAPY EXCISION

METASTATICChildren Neuroblastoma Ewing sarcoma Acute myeloid leukaemia

ACUTE MYELOID LEUKAEMIA

METASTATICAdult Breast Bronchus Prostate GIT

TREATMENTRadiotherapy HormonalChemotherapySurgery

ADJACENT STRUCTURESMaxillary ca.Ethmoidal ca.

N P

PRESEPTAL CELLULITIS

ORBITAL CELLULITIS

CAPILLARY HAEMANGIOMA

CAPILLARY HAEMANGIOMA

BILATERAL ORBITAL INVOLVEMENT BY LYMPHOMA

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