Proptose

Proptose is a term used in some medical sources to describe forward displacement or protrusion of an orbital structure, most commonly the globe. However, proptosis is the standard term in ophthalmology for forward displacement of the eyeball within the orbit, sometimes called exophthalmos when the protrusion is pronounced. The term proptose appears infrequently and is often considered a nonstandard or obsolete variant; its precise usage is inconsistent across languages and disciplines. The word derives from Greek pro- “forward” and ptosis “falling.”

Causes and presentation: Proptosis/proptose may arise from inflammatory, vascular, neoplastic, infectious, or traumatic conditions that increase orbital content or push the globe forward. Common etiologies include thyroid-associated orbitopathy, orbital tumors (e.g., lacrimal gland, meningioma), inflammatory pseudotumor, orbital cellulitis, hemorrhage after trauma, carotid-cavernous fistula, and vascular malformations. Patients may report eye fullness, diplopia, or blurred vision; eyelid retraction and exposure keratopathy can occur. An emergent workup is warranted if there is rapid onset or pain, or signs of optic nerve compromise.

Diagnosis and management: Evaluation relies on clinical examination, exophthalmometry measurement, and imaging with CT or MRI to identify cause and extent. Management targets the underlying condition: immunotherapy or steroids for inflammatory causes, antibiotics for infection, oncology treatment for tumors, or surgical orbital decompression for selected thyroid eye disease or space-occupying lesions. Acute proptosis due to vascular events or hemorrhage may require urgent intervention to protect vision.