Proptosis Causes, Diagnosis, and Treatment

Proptosis or exophthalmos is a term to describe the protrusion or bulging of one or both eyes. Exophthalmos is a term used more in the context of bulging eyes due to Graves disease, a condition caused by hyperthyroidism.

Proptosis itself could bring forth more symptoms as explained by Earth Vision Eye Care. These include dry eyes or irritated eyes because the bulging prevents the eyelids from closing correctly. Also, with proptosis, people tend to blink less or seem to stare in a more pronounced way. Various symptoms could be difficulty focusing on objects or double vision.  Prolonged bulging may cause the optic nerve to stretch or get pinned underneath, thus affecting vision.

Causes of Proptosis: The primary cause of proptosis is Graves disease, which brings about the swelling of the tissue surrounding the eye, forcing the eyeball to protrude slightly. Children who are suffering from this condition are more prone to eye infections. Other different causes include tumors, bleeding, infections, and inflammation. Congenital glaucoma makes the eyes look enlarged for the same reason that pressure causes a slight protrusion.

What are the telltale signs of proptosis? Do you need to see a healthcare expert soon? Look for these symptoms:

1)    Double vision or reduced quality of vision

2)    Fever

3)    Eye pain

4)    Headache

5)    Pulsing sensation in the bulging eye

We need a more in-depth discussion on this issue: which types of proptosis are more critical or urgent?  First, it is essential to differentiate rapid bulging versus the bulging that took place over the years. Rapid bulging seems to imply bleeding somewhere in the eye, which can be the result of injury, surgery, inflammation, or infection.  The slow bulging suggests Graves disease (which by the way, affects both eyes) or a tumor in one eye socket. During the examination, an instrument known as a slit lamp will be used; it enables the doctor to monitor the eye movement closely.

The different signs which doctors will look for include the symptoms of hyperthyroidism: a spike in the heart rate, tremors, and a tender or bloated thyroid gland.  

Treatment: Strange as it seems, treatment of proptosis include using artificial tears as lubrication. Artificial tears protect the cornea. If lubrication turns out to be an unsuccessful remedy, surgery will correct the coverage of the eye surface.       

The surgery for orbital decompression employs general anesthesia. Orbital decompression (involving the extraction of bony and fat removal, also known as debulking) is performed for medical emergency purposes. Although less work is needed for cosmetic orbital decompression, the surgical principle remains the same, wherein orbital fat and orbital is extracted or reduced.

Treatments also vary according to the culprit behind the bulging. Antibiotics are given only for infections. As for the bulging caused by Graves disease, treating thyroid problems will not affect the condition as much, although the bulging will decrease. Swelling related to Graves disease may be mitigated using corticosteroids. Tumors can be removed to alleviate the symptoms of Graves disease.