3 Noninfectious CausesBlunt Trauma-increased swelling x48hrs then resolves over several daysTumor-gradual onset of proptosis in the absence of inflammationHemangiomas of the lidOcular tumors-retinoblastoma, choroidal melanomaOrbital neoplasms-neuroblastoma, rhabdomyosarcoma
4 Noninfectious Causes Cont. Local edema-hypoproteinemia and congestive heart failureBilateralBoggyNontenderNondiscoloredAllergic inflammationContact hypersensitivityAngioneurotic edema
9 Symptoms Eye Pain with movement or Restricted eye movement Painful swelling of upper and lower lidsProptosisDecreased Visual AcuityFeverIll appearing
10 History Recent sinusitis or upper respiratory tract infection Fever or malaiseRecent facial trauma or surgery, dental workInfection elsewhere in the body
11 Physical Exam Proptosis Ophthalmoplegia Conjunctival chemosis Decreased visionElevated intraocular pressurePain on eye movementOrbital pain and tenderness are present early.Dark red discoloration of the eyelids, chemosis, hyperemia of the conjunctivaPurulent nasal discharge may be present.