The Prevalence and Pattern of Paediatric Proptosis in the Ophthalmology Department, Kenyatta National Hospital, Nairobi, Kenya

Abstract

Background: Proptosis of the eyeball is a clinical condition that can manifest in pediatric patients with a wide range of etiologies and clinical features. Etiologies range from congenital conditions to tumors and inflammatory conditions. This study investigated the prevalence, clinical features and underlying causes of proptosis in pediatric patients in the ophthalmology department, Kenyatta National hospital. Method: A cross-sectional study was carried out on all patients less than but not including the age of 16 years from 1st January 2021 to 31st December 2022 in the ophthalmology department, Kenyatta National Hospital. Patient’s details were retrieved initially from the patient’s registry and patient’s files obtained from the medical reports department, KNH. Data of patients with clinical or radiological evidence of proptosis were collected in the data collection form. The data was uploaded into a spreadsheet software Excel 2019©. Results: Out of 1749 patients seen during the study period, 45 patients presented with proptosis, of which 41 had unilateral proptosis and 4 had bilateral. The prevalence of proptosis was therefore 2.6%. The most common age group with proptosis was 10-15 years at 40.0% of patients. Most patients presented with swelling of the eye as the chief complain. Twenty (20) eyes had no perception of light, while 18.4% of patients had melted cornea of which vision in the affected eye was no perception of light. Most common cause of proptosis was found to be tumour (44.4%) followed by inflammatory infectious conditions. Seven patients had retinoblastoma as the underlying etiology. Infection such as orbital cellulitis and abscess were the most common cause of inflammation compared to non-infective inflammation. Conclusion: The study found a high prevalence of proptosis in the pediatric population compared to other studies, with tumors being the leading cause, followed by inflammatory conditions. Patients with inflammatory conditions tended to present earlier than those with tumors or congenital conditions. These findings underscore the importance of early diagnosis and prompt, tailored management strategies, considering the varied presentations and impacts on ocular health, such as vision loss.