A normally located eyeball almost does not protrude beyond the orbital plane and is slightly shifted to the outer edge. If a person notices an abnormal pathological displacement of the eyeball in himself or others, this may indicate serious health problems.
The eye may move forward (exophthalmos or protrusion), backward (enophthalmos) and to the right or left side(lateral displacement). The nature of the displacement is determined by the underlying cause—the disease.
Protruding eyes or exophthalmos is a displacement of the eyeball forward, and in some cases - forward and to the side while maintaining it normal size and shapes. Unilateral exophthalmos is characterized by protrusion of one eyeball, bilateral - both.
The causes of exophthalmos in one eye lie in problems of the visual organs, and in both eyes - in problems of the endocrine organs, respiratory systems and other diseases. Pulsating exophthalmos almost always indicates diseases of the blood vessels of the eye or periocular tissues. There is a visual pulsation of the bulging eyeball. The pulsation exceeds the normal fluctuations of a healthy eye several times.
How does exophthalmos manifest?
If you look closely, you can even notice a barely beginning protrusion. Usually the sclera (the white layer of the eye) is between upper eyelid and not visible, but with bulging eyes it is clearly visible. At the same time, the patient blinks less often, which creates the impression of a continuous gaze.
Protrusion of the eye can be noticed directly by the patient during self-examination using a mirror, surrounding without special training and, of course, the doctor at the reception.
Due to infrequent blinking, the eyes are less hydrated, which is why exophthalmos is often accompanied by dry eyes, a feeling of “sand” in them, and irritation. When the eyeballs protrude greatly, the eyelids do not completely close the eyes during sleep. This creates problems with night sleep, especially at the stage of falling asleep, and is also fraught with mechanical damage to the cornea, including perforation.
Causes of exophthalmos
Exophthalmos itself is not a disease. This is rather a phenomenon accompanying painful conditions. Exophthalmos occurs due to pathological processes occurring in the orbit, skull, or some other diseases. In particular, the causes of exophthalmos are as follows.
What are the symptoms of exophthalmos
The symptoms of exophthalmos are as follows:
- noticeable protrusion of one or both eyeballs;
- pulsation in a pathologically located eyeball (not always);
- inability to close the eyes completely (in advanced or severe forms);
- dryness, pain, irritation, “sand” in the eyes;
- double vision;
- blurred vision.
The following symptoms are associated not so much with bulging eyes themselves, but with its causes:
- pain when rotating the eyeballs;
- difficulty controlling the eyeballs;
- headaches;
- noise and “whistle” in the ears;
- dizziness;
- fatigue and drowsiness.
Among the variety of ophthalmological diseases, two categories should be distinguished. Some pathologies can only be recognized with a special diagnostic equipment, while others are clearly distinguishable due to physical disorders in the visual apparatus. Exophthalmos is a disorder that is noticeable to the naked eye. It is typical for the eyeball to protrude or shift to one side. In today's article we will look at why this disease occurs and what methods of treating it exist.
Exophthalmos - what is it?
This term means quite rare disease. In everyday life you can find another name - “bulging eyes”. Its development is caused by a pathological increase in the number of retrobulbar tissues located in the orbital cavity. The cause of this disorder, in turn, is inflammatory, neurodystrophic or traumatic processes. Manifestations of exophthalmos can occur at any age.
The first case of bulging eyes in medicine was recorded at the end of the 18th century and was caused by a disease of the thyroid gland. However, pathology received a detailed description only in the middle of the 20th century. Since that time, its active study began. Many doctors believe that exophthalmos is a manifestation of one or more diseases, and not an independent disorder. The first ones are not always associated with the visual apparatus; sometimes the cause is hidden in a functional disorder of other organs. Therefore only differential diagnosis allows you to identify the source of the disease and correctly select therapy.
Main reasons
It should immediately be noted that various malfunctions visual organs cannot be the cause of exophthalmos. On the other hand, a disease left without timely treatment often provokes the development of complications. Among them, the most dangerous is considered to be complete loss of vision.
Numerous studies of patients with this disease have confirmed that damage to the eye tissues characteristic of exophthalmos is caused by a malfunction immune system. In this case, the patient’s adipose tissue in the orbit swells, then motor muscles join this process. This phenomenon affects both eyes, but initially appears in only one.
Among other reasons pathological process doctors highlight the following:
- inflammation blood vessels, lacrimal glands eye;
- congenital glaucoma;
- varicose veins of the orbital veins;
- various injuries causing hemorrhages;
- orbital tumors;
- paralysis of the external muscles of the eye.
Also, the causes of the disease can be processes of a local nature. For example, diffuse toxic goiter, hypothalamic syndromes, aneurysms, thrombosis, hydrocephalus.
Clinical picture
The severity of the symptoms of exophthalmos depends on the degree of protrusion of the eye. A barely noticeable disturbance causes virtually no discomfort to the patient. As the disease progresses clinical picture modified and supplemented with the following features:
- swelling and redness of the sclera;
- decreased visual acuity;
- double vision.
Due to the displacement of the eyeball, the patient loses the ability to close the palpebral fissure. Therefore, he gradually develops keratopathy. Pathology leads to infection and ulceration of the cornea.
Classification of exophthalmos
The disease is usually classified into imaginary and true. In the first case, the pathological process develops against the background of severe myopia. B A more serious variant of the disease is true exophthalmos. What it is? The disease occurs due to tumor or inflammatory disorders. It can occur in both acute and chronic forms.
True exophthalmos, in turn, is divided into the following types:
- constant;
- throbbing;
- progressive malignant;
- intermittent.
There is also unilateral exophthalmos and bilateral (affects both eyes).
According to another classification, there are three types of bulging eyes: thyrotoxic, edematous and endocrine myopathy. Now let's take a closer look at what each of them is.
Thyrotoxic exophthalmos
This type of disease occurs predominantly in females. Its development is preceded by poisoning of the thyroid hormones of the thyroid gland. Soft tissues are not involved in the pathological process. Upper muscles ocular orbit, responsible for the movement of the eyelid, spasm and noticeably increase in size.
As the disease develops, a significant expansion of the palpebral fissure occurs. At first the changes are asymmetrical. Gradually the palpebral fissure becomes deeper and wider. At the same time, other ophthalmological disorders appear: it becomes difficult for the patient to blink and look at nearby objects. Outwardly, it seems that such a person has “bulging eyes.”
Deficiency causes abnormal shine of proteins. Whenever the patient tries to close his eyes, they begin to twitch upper eyelids. Their inhibited reaction is observed to the movement of the pupil and cornea.
Edema exophthalmos
The reasons for the development of this form of the disease still remain poorly understood. To date, the etymology is clearly clear in only 70% of patients. In half of the cases, the pathological process is endocrine in nature. In 10%, the disease develops against the background of infection. Doctors associate the remaining 10% with the patient’s medical history and lifestyle.
The edematous form is characterized by severe protrusion of the eyeball. In most cases, the pathology is bilateral. Only 10% of patients have exophthalmos of one eye. Wherein painful sensations can be so strong that patients are prescribed narcotic painkillers.
If treatment is not started promptly, the disease can lead to keratitis. This is an inflammation of the cornea, in which vision rapidly deteriorates.
Endocrine myopathy
The nature of this form of the disease is closely related to hormonal changes in the thyroid gland. Its development is facilitated by either excessive release of hormones or their acute deficiency. Among the main causes of the disorder, doctors name stress, radiation exposure, and genetic predisposition.
The main symptom of endocrine myopathy is visual impairment, when all objects literally begin to split into two. Then there is a restriction in the mobility of the eyeball. After about 4-5 months, fibrosis develops - uncontrolled growth of intraocular tissue.
Diagnostic methods
If you suspect exophthalmos, you should immediately contact the nearest ophthalmology department. Only a qualified specialist can diagnose the disorder and select appropriate therapy. An ophthalmologist deals with this issue. To confirm the disease, it is enough for him to conduct one study - exophthalmometry.
During the procedure, a special ruler is used. Using a scale with divisions, the doctor determines the size of the cornea and compares the tops of its protrusions. After this, the size of the palpebral fissure and the presence of other diseases in which complete closure of the eyelids is impossible are taken into account.
Depending on the results of the study, the ophthalmologist determines the severity of the pathological process. When the size of the cornea exceeds 20 mm, and the difference between its highest points is more than 2 mm, we speak of exophthalmos. What it is, why it occurs and how to deal with it - these questions should be answered by the doctor right at the appointment.
In parallel with exophthalmometry, the patient is prescribed a series of additional research(ultrasound of the thyroid gland, hormone analysis, checking the state of the immune system, etc.). Based on the results complex diagnostics the ophthalmologist selects treatment.
Treatment Options
Protruding eyes or exophthalmos is a serious pathology that requires medication or even surgical intervention. Normalize the functioning of the visual system, relieve inflammation from the muscles and return the eyeballs to their place through recipes traditional healers does not seem possible. The disease should be treated by an endocrinologist and an ophthalmologist, and if surgery is necessary, by a surgeon. Therapy can take from several months to 2-3 years.
Treatment of exophthalmos is always prescribed on an individual basis. In this case, the doctor must take into account the severity of the pathology, the patient’s medical history, and the presence of concomitant ailments. Therapy is considered completed successfully if the main symptoms have been relieved.
Used to fight disease various drugs. For example, to eliminate swelling, Lasix, Furosemide or Diacarb are prescribed. To normalize cellular metabolism, Actovegin and Proserin are used. If it is necessary to stop inflammation, the doctor may prescribe Dexamethasone or Prednisolone. At serious problems with thyroid gland requires use hormonal drugs. Their use should be strictly supervised by a doctor.
When conservative methods no cure desired results, recommended surgical intervention. Standard surgery involves widening the orbit by removing the orbital walls. Additionally, they relax the eye muscles.
Prognosis for recovery
The causes of bulging eyes may vary in each specific case. Therefore, the prognosis for recovery will depend on the following factors:
- timely diagnosis;
- degree of severity of pathology;
- correctness of the prescribed treatment;
- individual characteristics of the body.
With mild and moderate degree exophthalmos prognosis is favorable. In more serious cases, surgical assistance may be required.
Prevention methods
For a disease such as exophthalmos, the main symptom is “bulging eyes.” This is a rather unpleasant disorder that requires proper treatment. Is it possible to prevent its occurrence?
According to leading ophthalmologists, the basis for preventing this disease is a healthy lifestyle. It is important to eat properly and rationally, try to eradicate all bad habits, avoid stressful situations. If you have any ophthalmological diseases, it is necessary to start therapy in a timely manner and not neglect the recommendations of the attending physician.
The organs of vision and head should be protected from traumatic injuries. If you suspect a thyroid pathology, you should immediately contact an endocrinologist and undergo an examination.
Unfortunately, there are quite a lot of different eye diseases: some of them can only be determined using special ophthalmological equipment, while others are clearly identified due to physical changes in the organ of vision.
Exophthalmos is a pathology that can be seen with the naked eye. When it occurs, the eyeball protrudes forward and may be displaced to one side.
The disease is a secondary symptom of some diseases internal organs or an individual, innate feature of the body.
What is exophthalmos
With the disease, a gradual increase in tissue volume occurs in the retrobulbar space of the organ of vision, which contributes to protrusion of the eyeball.
Pathological development of tissues occurs due to inflammatory, traumatic or neurodystrophic changes of a local or general nature.
Boggle-eyed on late stages its development is noticeable to the naked eye. The pathology can progress over several years or develop in two to three weeks.
With significant protrusion, the mobility of the eyeball is limited and vision deteriorates. In ophthalmic diseases, exophthalmos usually develops in one eye, with common diseases on both.
The disease develops regardless of the gender and age of the patient.
Classification
It is customary to classify illness into imaginary and true.
- Imaginary exophthalmos is detected with congenital asymmetry of the orbits, widening of the palpebral fissure, abnormal development cranium.
- True occurs in inflammatory, general diseases, injuries and tumors.
According to the nature of the disease, it is divided into constant, intermittent and pulsating.
- Constant exophthalmos in most cases occurs due to neoplasms in the orbital cavity.
- Intermittent occurs due to pathology of the orbital veins. This form of the disease is characterized by the appearance of protrusion only at the moment of physical stress, during which the blood supply to the vessels of the eye increases.
- Pulsating form of the disease occurs with the development of an aneurysm of the arteries of the eye, injuries. A characteristic symptom is a pronounced and noticeable pulsation on the eye and recording of noise in the upper part of the apple with the eyelid closed. Along with the main signs, it is recorded headache, noise in ears. Later, the veins on the forehead and temples noticeably expand.
- Developing quickly hypothalamo-pituitary a form of the disease associated with an increase in the synthesis of pituitary hormones. Swelling of the eyelids increases over several days, chemosis of the conjunctiva is detected, and paresis of the oculomotor nerves develops.
There is usually no pain. Edematous exophthalmos with diffuse toxic goiter can develop both due to improper functioning of the thyroid gland and after it complete removal, which is associated with hormonal imbalance.
Causes
The reasons are divided into general and local.
Local provoking factors include:
- Inflammatory processes in the orbit or adjacent areas. Local causes also include eye injury, pathology of the eye veins, and neoplasms in the eyeball area.
- Common reasons – diffuse goiter, hydrocephalus, cranial development abnormalities, diseases hematopoietic system. Inflammation of the nasal sinuses can also be a provoking factor for exophthalmos.
Symptoms
The clinical picture depends on the degree of protrusion of the eyeball. A barely noticeable protrusion does not cause discomfort to the patient. As the pathology progresses, the following symptoms may occur:
- Swelling and redness of the sclera.
- Double vision and decreased vision.
- Incomplete closure of the eyelids leads to the development of dry sclera, resulting in the development of keratitis.
- The absence of movement of the eyeball or its severe limitation is a sign of a neoplasm or acute inflammatory process in the orbit.
- Upon examination, they are found pathological changes fundus – hemorrhages, neuritis, nerve atrophy.
Prolonged compression of the optic nerve and its swelling lead to complete blindness, which cannot be corrected in the future.
Diagnostics
Only an ophthalmologist can diagnose exophthalmos by conducting a special study called exophthalmometry. It is performed using an exophthalmometer or a special ruler.
Using a scale with divisions, the doctor determines the size of the cornea and compares the tops of its protrusions. After this, the size of the palpebral fissure and the presence of any eye diseases, in which complete closure of the eyelids is impossible.
Depending on these data, exophthalmos is divided into mild degree, medium and pronounced. Any values of corneal dimensions during exophthalmometry that exceed 20 mm, as well as a 2 mm greater difference between highest points protruding corneas are considered abnormal. A value of 28 mm or more is considered pronounced.
In parallel with the procedure for measuring the size of the eyes, it is necessary to conduct tests and studies of other organs that may be related to the problem: Ultrasound thyroid gland, checking the state of the immune system, analyzing hormones, checking for the presence of abnormal processes in the eye sockets using isotope diagnostics and x-rays.
Treatment
The diagnosis is made on the basis of the clinical picture, history taking, full examination. Exophthalmometry allows you to determine the degree of protrusion.
For successful treatment It is necessary to establish the main cause of the pathology, so the patient is treated not only by ophthalmologists, but also by endocrinologists, otolaryngologists, neurosurgeons, therapists, and neuropathologists.
Main stream therapeutic measures is selected based on the identified cause of the pathology.
- For diseases of the thyroid gland, treatment is carried out by an endocrinologist. Microdoses of iodine, Mercazolil, radioactive iodine. The choice of drug depends on hormone tests. Depending on the level of hormones, pulse therapy using prednisolone may also be prescribed.
- At inflammatory phenomena use antibiotics, sulfonamides, vitamin therapy, and sedatives.
- Pulsating exophthalmos in trauma is treated using pressure bandage, which allows thrombosis of the damaged vessel. Additionally, hemostatic agents are prescribed.
- Oncological tumors are treated with chemotherapy and radiation therapy. Surgery is used to remove the tumor.
- If compression of the optic nerve is detected, a decision is made to perform an operation aimed at reducing the pressure in the membranes of the eyes. In some cases, only surgery can minimize the risk of developing complete blindness.
Forecast
Since in each individual case of the disease the causes may be different, the prognosis will depend on:
- from a specific diagnosis;
- from the timeliness of diagnosis;
- on the severity of exophthalmos;
- on the correctness of the chosen treatment;
- from individual characteristics;
- from the totality of all of the above.
With mild to moderate exophthalmos, the prognosis can be favorable if the exact cause or causes of the disease are identified in time and corrected correctly by contacting specialists.
For any form of exophthalmos, your doctor may recommend surgery ( Plastic surgery), further actions will depend on the underlying cause of the eye disease.
Prevention
First of all, prevention should include healthy image life: proper nutrition, moderate physical activity, giving up bad habits, avoiding stressful situations; This will boost the immunity of the whole body.
If you are being monitored by a doctor due to any disease, then you need to follow all his recommendations so that there are no complications with the disease, which may manifest themselves in diseases of the visual organs.
You should especially protect your head and eyes from injury when dangerous species activities, monitor eye hygiene, treat infectious and inflammatory diseases of the ENT organs in a timely manner, if you suspect a malfunction of the thyroid gland, undergo an examination, take general analysis blood.
Conclusion
Any disease can develop as a result of inattention to one’s health, this is both a reason for lack of time, and simply an unwillingness to change something. Exophthalmos is also one of these diseases, therefore, in order to avoid a risk to vision or even the danger of losing it completely, it is necessary to follow preventive measures and attend medical consultations.
If you are concerned about your eye health, do not empty space, and the doctor does not confirm your doubts, visit another doctor to listen to several opinions and make a decision. It is always easier to prevent a disease and the chances will be much greater if treatment is carried out on early stage detection.
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People with thyroid eye disease have suffered from thyroid dysfunction in the past or will in the future
Thyroid disease can affect the eyes, causing the muscles and soft fabrics the inside of the eye sockets swell. This pushes the eyeball forward and causes various eye symptoms. Treatment includes measures to protect the eyes: the use of artificial tears, medications, and in some cases even surgery. The thyroid disease itself also needs to be treated.
Swelling of the muscles and fatty tissue of the eyes
When thyroid disease affects the eyes, there is swelling of the muscles and fatty tissue surrounding the eyeball within the orbit (eye socket). Edema is associated with inflammation of these tissues. There is limited space inside the orbit of the eye, so when the tissues swell, the eyeball moves forward. This causes the clear window at the front of the eye (cornea) to lose its protection. The eyeball cannot move as easily because the muscles now have less control over it. When the disease is very severe, the nerve connections from the eyeball to the brain can become compressed and damaged. This period of swelling is accompanied by healing.
Thyroid eye disease also called thyroid ophthalmopathy, dysthyroid eye disease, ophthalmopathy, or ophthalmic Graves' disease.
Causes of thyroid eye disease
The thyroid gland is a small, butterfly-shaped gland that is located at the top of the throat (trachea) at the front of the neck. She plays important role in controlling the speed at which chemical reactions occur in body tissues (metabolic rate). The thyroid gland may become overactive or underactive. It is most often associated with an autoimmune disease.
Autoimmune diseases and the thyroid gland
The immune system usually creates small proteins (antibodies) that can attack foreign organisms (bacteria, viruses). In people with autoimmune diseases, the immune system produces antibodies against the body's own tissues. It is not yet clear why this happens. Some people develop autoimmune diseases: their immune system attacks the body's own tissues. Autoimmune thyroid disease (See article:) occurs when the body's antibodies attack the gland. In some people, these same antibodies can also attack the tissue surrounding the eyeball. This is a thyroid eye disease. It is not known why this occurs in some people and not others. Therefore, thyroid eye disease is an autoimmune disease that is most often associated with an overactive thyroid gland. In some cases, thyroid eye disease occurs even when thyroid works fine. However, people with thyroid eye disease usually have a history of thyroid dysfunction or are beginning to experience thyroid dysfunction.
Prevalence of thyroid eye disease
This rare condition affects approximately 16 women and 3 men out of 100,000 people each year. Most of these people have problems with an overactive thyroid gland, which is due to an autoimmune condition. This usually occurs in middle age. Some people have genes that increase their risk thyroid disease eye. In addition, this risk is increased in smokers.
Symptoms of thyroid eye disease
Symptoms cause swelling in the tissues of the eye socket and push the eyeballs forward: 1) The eyes may become red and irritated because the cornea is affected and poorly lubricated. 2) There may be dry eyes because the production of tears by the lacrimal glands is impaired. 3) Your eyes may hurt. 4) Eyes may appear more prominent. 5) Double vision (diplopia) may develop because the muscles become too swollen to work properly.6) On late stages With the disease, vision may become blurry and colors may appear less vibrant. The two eyeballs are not always affected to the same extent.
Diagnosis of thyroid eye disease
The diagnosis can be made simply by examining the eye if thyroid disease is already known. Blood tests are sometimes performed to confirm the diagnosis. Hormone levels in the blood can indicate how well the thyroid gland is functioning. More specific tests blood tests may be done to measure the level of antibodies in the blood.
You need to do an ultrasound of the thyroid gland to see how actively it is working. If your doctor is particularly concerned about eye orbital swelling, he or she may order an MRI, which will determine which tissues are most affected. The doctor should also evaluate how well you see colors, as well as peripheral vision. An eye movement test may be done to show which muscles have been affected by the autoimmune process. These assessments should be carried out throughout the illness.
Treatment of thyroid eye disease
If thyroid eye disease is left untreated, the inflammation should resolve on its own within a few months or years. However, symptoms caused by swelling (such as bulging eyes) may remain permanent because some of the tissue that has been stretched may not always return to its original shape. The goal of treatment is to limit the damage caused during the period of inflammation. Treatment of thyroid eye disease requires joint efforts of an ophthalmologist and an endocrinologist.
Drugs for the treatment of thyroid eye disease
At an early stage of the disease and when this disease occurs in soft form, artificial tears are used, but they may not be enough. As the disease progresses, you may need immunosuppressants, a family of drugs that suppress the immune system that produces abnormal antibodies. Commonly used immunosuppressants are steroids such as prednisolone. You may also need to take certain other medications (omeprazole protects the stomach lining) to counteract some of the more common side effects of steroids. If you have a very severe illness, your doctor may prescribe a course of steroids given through an IV.
Surgical treatment of thyroid eye disease
About 5 in 100 people with thyroid eye disease have severe disease, resulting in optic nerve(the connection between the back of the eyeball and the brain) shrinks. This can damage your entire vision. In this case, the doctor may decide to organize decompression. This is a procedure that creates space in the orbit for inflamed tissue to spread. This relieves pressure on the nerve. In some cases it may be carried out surgery, allowing you to move the eyeballs back. Sometimes surgery to remove pulled muscles allows you to return everything to its place. If there are problems with elongated tissues that need surgical correction after the inflammation has passed, the operation is performed in the orbit, and then on the muscles.
Other Treatments for Thyroid Eye Disease
If double vision (diplopia) develops, your doctor may prescribe modified glasses that block vision from one eye; or cover your eyes with a special prism to stop diplopia. Radiation therapy(treatment by exposure to a radioactive substance) may be used for some individuals. The goal is to reduce swelling in the eye. It is used along with other forms of treatment. There are a number of new treatments for thyroid eye disease that are being studied. In addition, the doctor will treat abnormal thyroid function. For this purpose, medications (radioactive iodine) or thyroid surgery will be prescribed.
Advice for patients with thyroid eye disease: 1) Smoking worsens the disease, so stop smoking bad habit. 2) Bright light can irritate the eyes, in which case they will be useful Sunglasses. 3) If you drive a car and have double vision, be sure to control it with prism glasses.
Complications of thyroid eye disease. Most people do not develop permanent complications. However, they do occur in some people, especially those whose treatment is delayed or whose disease is severe. More often, complications occur in older people, as well as in smokers and patients diabetes mellitus. Possible complications: 1) damage to the cornea; 2) constant squint or double vision; 3) damage optic nerve, which leads to decreased vision or color perception; 4) unsightly appearance.
Complications due to treatment: 1) side effects due to the use of immunosuppressive drugs. 2) side effects due to surgery: double vision (in 15 out of 100 people with thyroid eye disease); loss of vision (less than 1 in 1,000 people with thyroid eye disease).
Thyroid eye disease is a long-term illness. The period of inflammation lasts from several months to several years (usually about two years). However, in most people this disease occurs in mild form and requires the use of only artificial tears, as well as regular vision examinations. Then this disease goes away on its own. For patients with severe thyroid eye disease, the prognosis depends on how early the diagnosis is made and how intensively treated. About 1 in 4 people will eventually have reduced vision.
The most common factors for the appearance of exophthalmos are ophthalmological diseases, work disorders endocrine system and skull injuries. Treatment of bulging eyes is primarily intended to eliminate main symptom disease, due to which the pathology arose. Exophthalmos can develop in any person, regardless of age or gender.
Bug eyes most often negatively affect visual acuity, and in the absence of correct
treatment goes into malignant form pathology. The pathology of exophthalmos is also called bulging eyes. This name is considered completely justified, since during such processes the eyeballs protrude significantly forward, creating the characteristic effect of bulging eyes.
Bug eyes occur due to the displacement of the eyeballs, which is why the eyes begin to move forward or to a certain direction. In this condition distinctive feature considered a white gap that is noticeable between the iris and the upper eyelid, this is especially pronounced when looking down. At the same time, the color of the skin of the eyelid itself changes - the skin in this place begins to become much darker.
The development of exophthalmos is provoked by pathological increases in the number of retrobulbar tissues contained in the orbital cavity. This disorder occurs in inflammatory, traumatic or neurodystrophic diseases.
The first recorded case of bulging eyes occurred at the end of the 18th century and was associated with a disease of the thyroid gland. But this pathology was described in more detail only in the middle of the 20th century. From that time on, the process of active study of the lesion began.
Many treating specialists argue that exophthalmos is a manifestation of one or many diseases at once, and not an independent disorder. Diseases may not always be directly related to the human visual system; in some cases main reason hidden in functional disorders organs. That is why only a differential study will help identify the source of the disease, as well as correctly select treatment therapy.
Various difficulties in the functioning of the visual organs cannot cause exophthalmos. On the other hand, left without proper treatment pathology often provokes the development of serious lesions. The most dangerous of these is considered to be loss of vision.
Multiple studies of patients with such lesions have helped to confirm that damage to the ocular tissues that describe the course of exophthalmos may be associated with disturbances in the functioning of the immune system. In this case, the patient’s adipose tissue in the orbit begins to swell greatly, and then the motor muscles also join this lesion. Such processes affect two eyes at once, but initially appear only in one.
Among other reasons for the development of the pathological process, doctors usually identify:
Also, the main factors for the development of bulging eyes can be processes of local spread - for example, diffuse toxic goiter, aneurysms, thrombosis, hypothalamic syndrome, hydrocephalus.
The severity of symptoms in a bug-eyed person will directly depend on the rate of eye protrusion. A minor violation causes almost no pain or other discomfort to the patient. As the degree of disorder develops and worsens, the clinical picture begins to change, and Protruding eyes are accompanied by some symptoms:
- swelling and redness of the sclera;
- decreased visual acuity of the patient;
- occurs .
Due to changes in the position of the eyeball, the patient loses the ability to normally close the palpebral fissure. This is why keratopathy occurs over time. Pathologies lead to the development of infection and ulceration of the cornea.
Bug-eyedness manifests itself in completely different ways, but in medicine it is customary to distinguish three main types:
Slight protrusion of the eyes from the sockets (from 15 to 18 millimeters), which is considered absolutely normal. When bulging eyes develop, you need to go through comprehensive examination at the doctor for diagnosis accurate diagnosis. Exophthalmos can be cured only by defeating the underlying disease.
The main pathologies that lead to exophthalmos:
It is possible to eliminate the signs of exophthalmos only with the intervention of a doctor of a narrower specialty.
Violation is usually divided into imaginary and true. With imaginary vision, the pathology actively develops against the background of myopia. A more serious form of damage is considered true exophthalmos. In this case, bulging eyes are actively developing due to inflammatory and tumor processes. It can occur in both acute and chronic forms.
True bulging eyes are also divided into several types:
- constant;
- throbbing;
- intermittent;
- progressive malignant.
According to the second classification, three types of exophthalmos are recognized: thioretoxic, endocrine myopathy and edema.
Thyrotoxic damage
This type of disorder occurs in most cases in women.. Its formation is preceded by the process of poisoning with thyroid hormone in the thyroid gland. In this case, soft tissues do not participate in the damage process at all. The upper muscles of the eye orbit, which are responsible for the mobility of the eyelid, spasm and become enlarged.
As the symptom progresses, a strong widening of the palpebral fissure begins to occur. In the first stages, the changes are asymmetrical and almost do not manifest themselves. But over time, the gap becomes larger and wider. Along with this process, other ophthalmological changes occur: the patient has to use some effort to blink and move his gaze from object to object. On appearance it may seem that the person's eyes are bulging.
A low level of tear fluid provokes an abnormal shine of the proteins. As soon as the patient tries to close his eyes, the upper eyelids begin to twitch unexpectedly. An inhibited reaction occurs when the pupil and cornea move.
The reasons for the development of this type of bulging eyes have so far been poorly studied.. Today, the etymology of the pathology becomes clear in only seventy percent of patients. In half of the cases, the pathology is endocrine in nature. In 10 percent it is formed along with infection of the body. Doctors are accustomed to associate the remaining ten percent with the patient’s medical history and poor lifestyle.
The edematous type of bulging eyes is described by a strong protrusion of the eyeball. Most often, bulging eyes are of a bilateral type. Only ten percent have exophthalmos in one eye. In this case, the pain can be so severe that the patient is prescribed narcotic forms of painkillers.
If you don't start timely treatment, the lesion may develop keratitis. This is an inflammation of the membranes of the cornea, in which the sharpness of vision very quickly decreases.
Endocrine disease
The nature of this form is closely related to hormonal disorders in the thyroid gland. This pathology is promoted by a strong release of hormones, or, conversely, their lack. Among the main causes of the disease, experts identify stress, emotional disorders, radiation exposure and genetic predisposition.
The main symptom is a disorder of the visual system, in which all objects nearby begin to double. Afterwards, you may notice a limitation in the mobility of the eyeball. After four to five months, fibrosis may develop - uncontrolled growth of tissue inside the eye.
Basic diagnostic methods
If you suspect the presence of an illness, you should immediately go to the nearest ophthalmology department. Diagnosis of the disease and selection of the correct treatment therapy can only be experienced doctor. An ophthalmologist deals with this issue. To confirm the disease, he only needs to conduct one study with the patient - exophthalmometry.
When conducting the study, a special ruler is used. Using a general scale with divisions, the doctor determines the diameter of the cornea of the eye and also examines its protrusions. After this, the width of the palpebral fissure is examined and the presence of diseases during which it is impossible to completely close the eye is checked.
Depending on the diagnosis received, the ophthalmologist determines the severity of the pathology. If the size of the eye socket exceeds a diameter of 20 millimeters, and the difference between its highest points is beyond the mark of two millimeters, then this indicates bulging eyes in a person. What it is and how to deal with it, the doctor will be able to answer at the appointment itself. Along with exophthalmometry, the patient is prescribed a number of additional procedures(ultrasound of the thyroid gland, diagnosis of hormones, checking the state of the immune system). Based on the research, the ophthalmologist selects the most appropriate treatment.
Possible treatment
A bulging eye is a serious lesion that requires medication or even surgical treatment. Normalize the activity of the visual apparatus, eliminate inflammatory processes in the muscles and return the eyeballs to their place with the help of recipes traditional healers It definitely won't work. Treatment should be carried out by an endocrinologist and an ophthalmologist; if necessary, a surgeon will join in and perform the operation. Therapy can last from two to three years.
Treatment of pathology is always prescribed based on the individual characteristics of the patient and the presence of pathologies in his body. In this case, the doctor is obliged to take into account the severity of the disorder, the form of bulging eyes and the presence of concomitant lesions of exophthalmos. Treatment is considered complete if the main problem has been eliminated and symptoms have been reduced.
To combat damage, various medications. For example, to get rid of edema, drugs are prescribed: Lasix, Diacarb and Furosemide. Proserin and Actovegin are used to normalize metabolism in cells. If there are serious problems with the thyroid gland, treatment is necessary hormonal agents. Their use must be under the full supervision of a physician..
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