==== Front
Ann Saudi MedAnn Saudi MedAnnals of Saudi Medicine0256-49470975-4466King Faisal Specialist Hospital and Research Centre 1652188110.5144/0256-4947.2006.65asm-1-65What”s Your Diagnosis?Sudden proptosis of the left eye in a Saudi male Al-Suleiman Ahmad M. From the Department of Medicine, King Fahad Hospital, Hofuf, Saudi ArabiaCorrespondence: Ahmad M. Al-Suleiman, MD, King Fahad Hofuf Hospital, Department of Medicine, Alhassa-Hofuf, P.O. Box 3432, Hofuf Alhassa 31982, Saudi Arabia, Tel: +966-505-929315, Fax: +966-3-5755150, suliman2000ww@yahoo.comJan-Feb 2006 26 1 65 65 Copyright © 2006, Annals of Saudi Medicine2006This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
==== Body
A 15-year-old male was admitted with sudden left eye swelling accompanied by mild left eye pain and left side headache, no history of trauma, no decrease in vision and no change in the level of consciousness. Examination revealed a young male with no pallor or jaundice and with stable vital signs. General examination was unremarkable. Eye examination revealed left eye proptosis downward and outward, mild keratopathy, no visual defect, normal intraocular pressure by digital palpation, a clear lens, no papilledema, and a partially dilated and reactive pupil. There was limitation of left eye movement in all directions.

What are the abnormal findings on the orbital CT scan (Figure 2)?

What abnormalities can be seen in the peripheral blood smear (Figure 3)?

What’s your diagnosis?

Answers on page 76

Figure 1 Photograph of the left eye.

Figure 2 CT scan of the orbits of the eye.

Figure 3 Peripheral blood smear.