Cornea & external disease · practice question
Which cause is far more likely in the adult than in the child?
[READINESS SEED] A clinician weighs the differential for unilateral proptosis, noting that the likeliest causes differ markedly between a young child and a middle-aged adult. Which cause is far more likely in the adult than in the child?
Show the answer and explanationAnswer and explanation
Answer: A. Thyroid eye disease
Thyroid eye disease is the commonest cause of proptosis in adults, whereas childhood proptosis is dominated by dermoid, capillary hemangioma, orbital cellulitis, rhabdomyosarcoma, and metastatic neuroblastoma. Knowing the age-specific differential shapes the work-up and urgency.
Clinical pearl: Age reframes the same sign: bilateral adult proptosis with lid retraction is thyroid until proven otherwise; rapid childhood proptosis is rhabdomyosarcoma until excluded.