Non-Pulsatile Exophthalmos [Neurosurgery Wiki]

This page is read only. You can view the source, but not change it. Ask your administrator if you think this is wrong.

====== Non-Pulsatile Exophthalmos ======

1. tumor

a) intra[[orbital tumor]]:may be due to mass effect from tumor or to compromised venous drainage from the orbit

● [[optic glioma]] 

● optic sheath neuroma

● lymphoma

● optic sheath meningioma

● orbital involvement with [[multiple myeloma]] 

● orbital invasion by [[invasive pituitary neuroendocrine tumor]] 

● in peds: metastatic neuroblastoma

● in peds: Langerhans cell histiocytosis as part of Hand-Schüller-Christian (triad: DI,
exophthalmos and lytic bone lesions (particularly of the cranium)) b) due to hyperostosis from a sphenoid ridge meningioma

2. Graves’ disease (hyperthyroidism + exophthalmos)): even though the exophthalmos is usually bilateral with this (80%), thyroid disease is still the most common cause of unilateral proptosis

3. enlargement of periorbital fat

4. infection: [[orbital cellulitis]] (usually has concomitant sinusitis)

5. inflammatory: orbital pseudotumor. Usually unilateral

6. hemorrhage

a) traumatic

b) spontaneous

7. 3rd nerve palsy: can cause up to 3 mm proptosis from the relaxation of the rectus muscles

8. cavernous sinus occlusion (may affect both eyes)

a) cavernous sinus thrombosis

b) cavernous sinus tumor obstructing venous outflow

9. pseudo-exophthalmos

a) congenital macrophthalmos (bull’seye)

b) lid retraction:e.g.in Graves’disease

c) coronal craniosynostosis can cause a “relative” proptosis