Exophthalmos is the unilateral or bilateral bulging or protruding of the eyeballs of their apparent forward displacement (with lid retraction). The prognosis depends on the underlying cause.
CAUSES
Exophthalmos commonly results from phthalmic Graves' disease, in which the eyeballs are displaced forward and lids retract. Unilateral exophthalmos may also result from trauma or may stem from hemorrhage, thrombosis and swelling, all of which similarly diplace one or both eyeballs. Other systemic and ocular causes include:
- infection: orbital cellulitis and infection of the tear (lacrimal) gland or orbital tissues
- tumors and neoplastic diseases: especially in children such as leukemia, gliomas of the optic nerve, dermoid cysts, teratomas, metastatic neuroblastomas and lymphoma; in adults— lacrimal glands tumors, mucoceles, and other neoplastic diseases.
- parasitic cysts: in surrounding tissue
- pseudoexophthalmos paralysis of extraocular muscle: relaxation of eyeball retractors, congenital macrophthalmia, and high myopia.
SIGNS & SYMPTOMS
The obvious sign as a bulging eyeball with or without pain.
TREATMENT
Effective treatment varies with the cause. for example, eye trauma may require cold compresses for the first 24 hours, followed by warm compresses, and prophylactic antibiotic therapy. After swelling subsides, surgery may be necessary.
eye infection requires treatment with broad-spectrum antibiotics during the 24 hours preceding positive identification of the causative organism, followed by specific antibiotics.
Treatment of Graves' disease may include antithyroid drug therapy or partial or total thyroidectomy to control hyperthyroidism; initial high doses of corticosteroids, such as prednizone, and, if lid retraction is severe, protective lubricants.