As seen from the photograph this seems to be a case of unilateral proptosis. History of no fever and as per photograph child does not seems to be very sick or toxic. Considering the unilateral proptosis following things should be considered.
1. Orbital Cellulitis,
2. Panophthalmitis,
3. Cavernous sinus thrombosis.
The diagnosis of the differential will be basically decided on detailed ophthalmic examination. Vision is generally preserved in early stages of cellulitis and Cavernous sinus thrombosis where here is complete loss of vision in panophthalmitis. Complete limitation of movement of occular muscles occurs in Cavernous sinus thrombosis , marked in orbital cellulitis and very less in panopthalmitis. If there is edema near the mastoid process it indicates the Cavernous sinus thrombosis. General symptoms are mild in orbital cellulitis and panophthalmitis but severe in Cavernous sinus thrombosis. As in this condition where systemic signs are less possibility of Cavernous sinus thrombosis is less.
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