Evaluation and Management of Childhood Proptosis: A Clinical study in a Tertiary Care Centre

BACKGROUND: Proptosis or exophthalmos is defined as protrusion of the globe beyond the orbital margins, with the patient looking straight ahead . Proptosis is the hall mark of orbital diseases. Childhood proptosis is quite different from that of the adult. While thyroid orbitopathy is the most common cause in adults, proptosis among children can be caused by: infection, inflammation, vascular and congenital developmental malformation and finally malignancies. AIM OF THE STUDY: To evaluate the various causes, incidence, mode of onset, various clinical presentations and to assess the various treatment modalities and the final outcome of treatment of childhood Proptosis. MATERIALS & METHODS: This descriptive study was conducted at Orbit and Oculoplasty Services, RIOGOH, Chennai for a period of 6 months. All Children upto 14 years of age presenting with proptosis were enrolled in the study, then evaluated and treated. RESULTS: Among 30 cases of childhood proptosis, Unilateral, Axial Proptosis with Lid edema is the most common presentation. Proptosis were more common in children under 4 years group. Inflammatory causes ranks the first (40%) followed by congenital conditions (26.7%) and neoplasia (20%). Orbital cellulitis (30%) is the single most common cause. Among the malignant causes secondaries (13.33%) were more common than the primary (6%). CONCLUSION: CT and MRI scans are the best modality of investigation in all cases of proptosis for early diagnosis and also helps to identify the extent of lesion in planning the further management. Inflammatory causes had better treatment outcome