What is Exophthalmos
Exophthalmos, also called proptosis, is a condition in which one or both eyes are positioned farther forward in the eye socket than normal.
The eyes look as if one or both eyes are bulging out or protruding. When the eyes are pushed forward, damage can be done to:
- The main nerve between the eye and the brain that contains the nerves for vision (optic nerve).
- The muscles that make the eye move.
- The inside of the eye because of increased pressure (glaucoma).
- The front surface of the eye (cornea) because of exposure and dryness.
What are the causes?
Exophthalmos is most often caused by an underlying condition, such as:
- Overactive thyroid (hyperthyroidism, Graves disease).
- Glaucoma.
- Anything
pushing the eyes forward from behind, such as:
- A tumor.
- Eye cancer.
- Bleeding behind the eye from a tumor or from blood vessel problems.
- Trauma that causes bleeding behind the eye.
- Problems with the arteries and veins behind the eye, such as an aneurysm.
- Cysts or a pus-filled area (abscess) behind the eye.
- Cancer of the blood system, such as lymphoma.
- Infection behind the eye.
- Eye injury.
What are the signs or symptoms?
The symptoms of exophthalmos may vary depending on the underlying cause. Symptoms may include:
- Bulging eye or eyes.
- Dry and irritated eyes.
- Eyes not closing all the way when asleep.
- More of the white part (sclera) of your eye being visible.
- Double vision, meaning that you see two of everything (diplopia).
- Trouble looking up with one or both of your eyes.
- Symptoms of the condition that is causing exophthalmos.
How is this diagnosed?
Your health care provider or eye doctor (ophthalmologist) will perform a physical exam and take a medical history. He or she can measure how far forward your eye is or your eyes are, compared to normal. Other tests may include:
- Blood tests.
- CT scan or MRI.
- Ultrasound.
- Other tests that are used to look at structures and areas around the eyes.
How is this treated?
Treatment involves finding the cause of exophthalmos and treating that underlying condition. The symptoms of exophthalmos may be relieved by:
- Medicines. These may include medicines to reduce inflammation.
- Surgery.
Surgery can relieve the pressure on the eyes. It can also free up the eye
muscles so the eyes can move properly. Surgery may be needed if:
- You have severe double vision.
- There is danger to your eyes.
- Corrective lenses. If you have mild double vision, it may be possible to relieve your symptoms with special glasses that contain prisms.
Contact a health care provider if:
- You have double vision.
- You have trouble looking up.
- You have new symptoms, or your symptoms get worse.
