A mysterious case of transient proptosis

Abstract

A 42-year-old Indian woman presented with a slowly progressive and painless swelling in the superomedial aspect of right orbit over past 5 years. She succumbed to homeopathic treatment which controlled the swelling for some time, but eventually recurred. The swelling led to protrusion of her right eye down and out. The patient's vision in her right eye was reduced, with restricted movement on elevation and adduction. The right eye pupil was sluggishly reacting to light. The fundus examination of the right eye revealed hyperemic disc with disc edema and retinal folds. Whereas, left ocular examination was normal. The computed tomography and magnetic resonance imaging scans of the right orbit revealed an intraconal, multiloculated lesion in the superomedial aspect of the orbit, adhering to the optic nerve, giving us an array of differential diagnosis. She underwent right anterolateral orbitotomy under general anesthesia; the masses excised were sent for histopathological examination, which gave the definitive diagnosis of a schwannoma.

Keywords

• eccentric proptosis
• neurilemmoma
• orbital schwannoma
• transient proptosis