A girl in her midteens with an unremarkable medical history was referred for evaluation of proptosis. She denied pain but described a pressure sensation behind her left eye. Uncorrected visual acuity measured 20/80 OD and 20/60 OS, improving to 20/40 OD and 20/30 OS with pinhole testing. Pupils were round and reactive without an afferent pupillary defect. There was moderate restriction to elevation of the left eye. Intraocular pressure was 18 mm Hg OU by applanation tonometry. Hertel exophthalmometer measurements demonstrated 7 mm of proptosis OS. Anterior segment and ophthalmoscopic examination results were unremarkable.
Francis AW, Setabutr P, Aakalu V. Proptosis in a Healthy Young Woman. JAMA Ophthalmol. 2016;134(7):837-838. doi:10.1001/jamaophthalmol.2015.6106