Download the full-detail poster card:

What's covered across 4 color-coded columns:

• Hertel measurement: >20 mm or ≥2-3 mm asymmetry = abnormal
• 6 etiologic categories: Inflammatory / Infectious / Neoplastic / Vascular / Trauma / Congenital - each color-coded with key entities
• Pseudoproptosis causes (myopia, lid retraction, contralateral enophthalmos)

• History: onset pattern (acute vs subacute vs chronic) guides diagnosis
• Inspect: direction of proptosis, lid signs (Dalrymple, von Graefe), pulsation, S-shaped lid
• Measure: Hertel exophthalmometer technique
• Palpate + auscultate: resistance to retropulsion, bruit for CCF
• Ocular motility: TED restriction pattern (inferior rectus first), forced duction test
• Visual function: color vision (earliest sign of optic nerve compression), RAPD, VF
• Slit lamp: corneal exposure keratopathy

• Blood panel: TFTs, TRAb, ANCA, ACE, IgG4
• Imaging: CT orbit (first line, bone/sinuses), MRI (soft tissue, ON, cavernous sinus), Doppler US
• CAS 7-item activity score - ≥3/7 = active TED, treat with immunosuppression

• TED pathway: Mild → Selenium + lubricants | Moderate-severe active → IV methylprednisolone protocol / Teprotumumab | Surgical (inactive, stable ≥6 months) → Decompression → Strabismus → Lids
• Orbital cellulitis Chandler grades I-V with treatment escalation
• Benign vs malignant neoplasm management
• Emergency box: Retrobulbar hemorrhage (lateral canthotomy), TED optic neuropathy (IV MP 1g × 3d), Mucormycosis (liposomal AmB + debridement)
• Direction-to-diagnosis chart (axial = intraconal, pulsatile = CCF/NF, intermittent = varices)