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A Neglected Cause of Proptosis

Robert H. Osher, MD; Jerry A. Shields, MD; Normal J. Schatz, MD

Arch Neurol. 1978;35(4):237-241.

Abstract
• Ten patients who had unilateral proptosis ranging from 2.5 to 4.0 mm were found to have axial myopia confirmed by ultrasonography and, in one case, by computerized tomography. The historical features emphasized include an acquired painless bulging eye, amblyopia, and a stable visual acuity. Noteworthy features on ophthalmologic examination include a difference in visual acuity and refraction between the two eyes, a difference in the lenses on inspection of the patient's glasses, and an ipsilateral myopic fundus. Careful history taking, examination, ultrasonographic evaluation, and inspection of old photographs will separate this group of patients and avoid unnecessary endocrine studies, angiography, and costly neuroradiologic investigations. Finally, it must be recognized that coexisting disease must be evaluated as if the proptosis did not exist.

Author Affiliations
From the Neuro-ophthalmology Unit (Drs Osher and Schatz) and the Ultrasonography Unit (Dr Shields), Retina Service, Wills Eye Hospital, Philadelphia. Dr Osher is now at Bascom Palmer Eye Institute, Miami.

Footnotes
Accepted for publication Aug 9, 1977.

Read before the annual Wills Eye Hospital Clinical Conference, Philadelphia, Feb 4, 1977.

Reprint requests to Ultrasonography Unit, Retina Service, Wills Eye Hospital, 1601 Spring Garden St, Philadelphia, PA 19130 (Dr Shields).

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