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Open Access
CC BY 4.0 · Arch Plast Surg
DOI: 10.1055/a-2719-8908
Review Article

Exploring the Etiologies of Acquired Unilateral Proptosis: A Literature Review with Case Presentations

Authors

  • Nam-Kyu Lim 

    1   Department of Plastic & Reconstructive Surgery, Dankook University College of Medicine, Cheonan, Chungnam, Republic of Korea

Funding Information This study was supported by the research fund of the Dankook University, 2024.
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Abstract

Acquired unilateral proptosis is a clinically significant condition with diverse etiologies, including trauma, inflammation or infection, tumors, and hemodynamic complications. This study aimed to improve recognition by integrating a literature review with illustrative case reports. Four representative cases were described, covering orbital infection, traumatic hematoma, carotid–cavernous fistula, and metastatic tumor. A focused literature review of publications from 2020 to 2024 was conducted, identifying 338 relevant studies, of which 171 met the inclusion criteria. Among the 171 eligible studies analyzed, tumors were the most frequent cause (93/171, 54.4%), followed by hemodynamic disorders (24/171, 14.0%), thyroid-related ophthalmopathy (13/171, 7.6%), infection, and inflammation. In tumors, metastatic tumor (n = 10) represented the most common subtype, followed by sarcoma (n = 9), retinoblastoma (n = 7), and lymphoma (n = 7). The four clinical cases aligned with these categories and illustrated a spectrum of outcomes—from irreversible vision loss in infection to visual preservation through timely endovascular intervention. This study provided a more detailed understanding of the diverse etiologies of acquired unilateral proptosis, suggesting the necessity of a multidisciplinary approach. Integrating these findings into clinical practice is expected to enhance early recognition, optimize treatment strategies, and ultimately improve patient outcomes.

Keywords

proptosis - exophthalmos - etiology

Data Availability Statement

Data are available from the corresponding author upon reasonable request.


Contributors' Statement

The author (N.-K.L.) performed all aspects of the study, including conceptualization, data collection, analysis, and manuscript writing.


Ethical Approval

The study was approved by the Institutional Review Board of our Hospital IRB number: 2019-07-018) and performed in accordance with the principles of the Declaration of Helsinki.


Informed Consent

All patients provided written informed consent for the publication and the use of their images.


Supplementary Material



Publication History

Received: 30 April 2025

Accepted: 06 October 2025

Article published online:
22 January 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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