Proptosis with ocular motility
restriction in a child represents one of the most
important ocular emergencies and must be an alarming
event for the ophthalmologist.
The varied anatomic structures within the orbit allow it
to host numerous disorders, including infectious,
inflammatory, immune mediated, vascular, and neoplastic
diseases.
While some of the diseases producing acute proptosis
(e.g., inflammatory pseudotumor) are labeled benign,
they almost always produce significant morbidity if
diagnosis and treatment are delayed.
Failure to properly diagnose malignant lesions producing
acute proptosis (e.g., lacrimal gland carcinoma) can
lead to both morbidity and mortality.
The clinical picture of proptosis may evoke the
specter of
Orbital
rhabdomyosarcoma
in which prompt diagnosis and early therapy can be
lifesaving, still others are relatively benign in every
sense , the
ophthalmologist should be aware of differential
diagnosis of proptosis in children
Orbital
rhabdomyosarcoma
should be considered in the differential diagnosis of
any child with a progressive unilateral proptosis
with ocular motility restriction.
Diagnosis consists of a detailed history, ocular
examination, imaging studies including CT or MRI, and
biopsy.
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