Malarvizhi Raman, Anuradha, Keerthana
BACKGROUND Proptosis in children usually presents as a diagnostic dilemma. This study is to evaluate the incidence, mode of onset, various clinical presentations in children up to 14 years. The various treatment modalities and the final outcome of treatment were also assessed. MATERIALS AND METHODS This prospective study was conducted at Orbit and Oculoplasty Services, RIOGOH, Egmore, Chennai for a period of 26 months from April 2014 to May 2016. Thirty patients presenting with proptosis were examined with detailed history taking, complete general examination and ocular examination, slit lamp biomicroscopy, ophthalmoscopy, Hertel’s exophthalmometry, colour vision, refraction, intra ocular pressure, perimetry, laboratory investigations, radiological investigations and histopathological evaluation were done to aid in the etiological diagnosis and to plan the management. RESULTS Of the total 90 patients of proptosis who attended the hospital during the study period, 30 were children upto 14 years of age (33.33%). 18 cases (60%) of patients presented with axial proptosis and 12 cases (40%) were eccentric. 25 cases (83%) presented with unilateral proptosis and 5 cases (17%) with bilateral proptosis. The common aetiologies for proptosis in children were inflammatory (33%) followed by neoplastic (20%) commonly secondaries. Among the inflammatory causes orbital cellulitis was the most common cause (30%). Leukemic infiltration was the commonest cause of proptosis due to secondary orbital infiltration. Among all cases inflammatory lesions had better outcome. Out of 30 cases majority (40%) got cured and showed clinical improvement by medical and surgical methods of treatment. CONCLUSION This study reveals that in children inflammatory condition is the predominant cause. Most of the cases were unilateral and axial in presentation. Overall the most common aetiology of childhood proptosis is orbital cellulitis. Among the malignancies, secondaries were more common than the primary orbital tumours. Haematological malignancy accounts for the majority of cases of orbital secondaries in children. Imaging techniques are the best modality of investigation in all cases of proptosis to detect the early lesions within the orbit.
