Acquired unilateral proptosis – an overview of aetiology and radiological considerations

Proptosis, a common sign with a broad differential diagnosis, is the anterior displacement and protrusion of one or both orbital globes. Patients present with varying degrees of chronicity, visual loss and associated symptoms, with some requiring urgent treatment. Proptosis can be axial, where the pathology lies within the extraocular muscle cone (intraconal) or non-axial, where the lesion is extraconal. In general medical parlance, proptosis and exophthalmos are often used interchangeably, but different authors have made distinctions in the terminology. Some clinicians utilise exophthalmos to signify anterior globe displacement related to underlying endocrine dysfunction, with proptosis referring to non-endocrine causes. Others distinguish according to severity, with proptosis implying protrusion of ≤18mm and exophthalmos protrusion of >18mm. For clarity, this article will use only the term proptosis.

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