Understanding Exophthalmos

A Comprehensive Guide to Bulging Eyes

Neurology

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Last updated: Mar 24, 2025

What is Exophthalmos?

Exophthalmos, also known as proptosis, is a medical condition where one or both eyes protrude or bulge forward from their normal position in the eye socket (orbit).

Common Causes

  • Graves' Disease - Most common cause (80% of cases)
  • Orbital Inflammation
  • Orbital Tumors
  • Orbital Trauma
  • Vascular Malformations

Key Symptoms

  • Forward projection of the eye(s)
  • Eye irritation and dryness
  • Difficulty closing eyelids completely
  • Double vision
  • Eye pain or pressure
  • Excessive tearing
  • Light sensitivity

Diagnosis

Physical Examination

  • Visual acuity testing
  • Exophthalmometry measurements
  • Eye movement assessment

Imaging Studies

  • CT scan of orbits
  • MRI
  • Ultrasound

Treatment Options

Conservative Management

  • Artificial tears
  • Ointments for nighttime use
  • Elevation of head while sleeping
  • Protective eyewear

Medical Treatment

  • Treatment of underlying condition
  • Corticosteroids when appropriate
  • Immunosuppressive therapy

Surgical Options

  • Orbital decompression surgery
  • Eyelid surgery

Complications

  • Corneal exposure and damage
  • Vision loss
  • Optic nerve compression
  • Cosmetic concerns

When to Seek Medical Care

  • Sudden onset of eye bulging
  • Vision changes
  • Severe eye pain
  • Difficulty moving eyes
  • Color vision changes

Prevention and Management

  • Regular eye examinations
  • Prompt treatment of underlying conditions
  • Smoking cessation
  • Protection from UV exposure

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