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Exophthalmos (Protrusion of The Eyeball) : Definition, Causes, Consultation and Treatment

Tuesday, September 25th 2012. | General

Exophthalmos Definition

Exophthalmos is a protrusion of the eyeball out of its orbit. The orbit is a cavity formed by bony walls. Inside the eyeball, extended back through the optic nerve, is the axis of the cavity. Around it, disperse fan ocular muscles surrounded by orbital fat. The bony framework is extensible, any element of this cavity expands, pushes the eyeball forward therefore causing proptosis.

Exophthalmos can come from either a change in the “container” (extraordinary loss of orbit size, except in the aftermath of trauma) or “content” (increase in volume of the eye or tumor) .

A person with exophthalmos is first examined by the doctor in search of corneal damage due to incomplete occlusion of the eye, inflammation of the conjunctiva, edema of the eyelids. Respect of eye movements may be clinically appreciated. It is desired visual disturbances associated with : double vision, decreased visual acuity near and far, blurred vision.

The attack is specified by an eye examination with measurement of exophthalmos, fundus and visual field in search of optic nerve damage.

 protrusion of the eyeball

Exophthalmos (img thanks to oncevic.rs)

Finally, the CT or MRI of the orbit can eliminate a cause tumor more accurately measure the degree of exophthalmos and help to monitor evolving.

The exophthalmia are only a symptom of a disease. The treatment will be the responsibility of the pathology.

Exophthalmos Causes

Exophthalmos can affect one eye or both eyes. We then say that it is uni – or bilateral.

The bilateral exophthalmos is most often caused by endocrine dysfunction associated with autoimmune thyroid : Graves disease or Hashimoto’s thyroiditis.

In 70% of cases, these are moderate exophthalmia, causing discomfort especially aesthetics.

The course is generally favorable. It can be much more serious – with inability to close the eyelid and cause blindness – in the absence of rapid response.

The unilateral exophthalmos may be related to different origins:

  • Infectious (orbital cellulitis in the aftermath of sinusitis)
  • Vascular (vascular fistula or angioma)
  • Trauma (hematoma) or
  • Tumor.

Your Consultation

  • When is exophthalmos occurred?
  • Is there any thyroid disease in the family?
  • Do you smoke?
  • Do you wear contact lenses and why?
  • Does your eyes tear?
  • Is that your eyes are sore?
  • Is what you see so well? Close? Far?
  • Do you see double?
  • Is that exophthalmos is more or less important depending on the day?

Ask and Question

“Is that my eyes are bulging stay forever? 

When the cause is Graves’ disease, the outcome is usually favorable, although some may persist exophthalmia with sequelae. In these exceptional cases, it is possible to return to the eye in the orbit in a specific surgical technique: the aesthetic outcomes are good. This surgery should only be performed after stabilization of the exophthalmos, which may take several years.

“I proptosis, is that I have a thyroid disease? 

It is very likely but it is necessary to be sure that it is proptosis. This disease must be sought by thyroid and antibody. It is possible that the thyroid is normal and that the disease occurs later but it is rarer. If your exophthalmos affects only one eye, do not hesitate to make a scanner to search for another cause.

“I have eyes” globular “but I am told that this is not an exophthalmos …”

This can happen, for example high myopia eyes can give a slightly “bulging” when the eyeball is firmly in the orbit. In this case, the appearance of the eyes is usually old.

In cases of hyperthyroidism, one frequently sees retractions of the upper eyelid without exophthalmia true. This retraction improves rapidly after treatment of hyperthyroidism.

“My exophthalmos occurred after the start of treatment my hyperthyroidism. Is this due to treatment? 

No, but it is possible that you made a transition to hypothyroidism, which increased exophthalmos already present but minimal. We must quickly bring you to a normal thyroid hormone levels, which should improve things.

“I exophthalmos due to Graves’ disease, how far can it go if I do not treat me? 

The exophthalmos untreated can have serious consequences up to and including blindness. It is imperative to treat and, in some cases, in an emergency.

“Is that I can continue to wear contact lenses? 

Yes, but you must be aware of the risk of conjunctivitis, protect your eyes from dust and sun and remove your lenses a few days in case of conjunctivitis. You must talk with your ophtalomogiste.

- When is exophthalmos occurred?

- Is there any thyroid disease in the family?

- Do you smoke?

- Do you wear contact lenses and why?

- Does your eyes tear?

- Is that your eyes are sore?

- Is what you see so well? Close? Far?

- Do you see double?

- Is that exophthalmos is more or less important depending on the day?

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