Exophthalmos

Exophthalmos, also known as proptosis, is a medical condition characterized by the protrusion or bulging of one or both eyeballs from their orbits.

Causes

• Graves' disease: an autoimmune disorder that leads to hyperthyroidism, causing inflammation and swelling of the tissues behind the eye, resulting in exophthalmos.
• Thyroid ophthalmopathy: a condition associated with Graves' disease, where the tissues around the eye become inflamed and swollen, pushing the eyeball forward.
• Tumors: such as orbital tumors, lacrimal gland tumors, or neuroblastoma, which can cause exophthalmos by occupying space in the orbit and pushing the eyeball forward.
• Infections: like orbital cellulitis or abscesses, which can cause inflammation and swelling of the tissues around the eye, leading to exophthalmos.
• Trauma: a blow to the head or face can cause bleeding or edema in the orbit, resulting in exophthalmos.
• Vascular anomalies: such as carotid-cavernous fistula or orbital varices, which can lead to increased blood flow and swelling of the tissues around the eye.

Symptoms

• Bulging of one or both eyeballs
• Redness and inflammation of the conjunctiva and eyelids
• Swollen eyelids
• Double vision (diplopia)
• Blurred vision
• Sensitivity to light
• Pain or discomfort in the eye or orbit

Diagnosis

Exophthalmos is typically diagnosed through a combination of physical examination, medical history, and imaging studies such as:

• Computed Tomography (CT) scans
• Magnetic Resonance Imaging (MRI)
• Ultrasound
• Orbital echography

Treatment

Treatment for exophthalmos depends on the underlying cause and may include:

• Medications: such as corticosteroids, antibiotics, or antiviral agents to reduce inflammation and swelling.
• Surgery: to remove tumors, repair damaged tissues, or decompress the orbit.
• Radiation therapy: to treat certain types of tumors or vascular anomalies.
• Orbital decompression: a surgical procedure to relieve pressure in the orbit and allow the eyeball to return to its normal position.

Complications

If left untreated, exophthalmos can lead to complications such as:

• Vision loss or blindness
• Corneal ulcers or exposure keratopathy
• Strabismus (crossed eyes)
• Cosmetic disfigurement