What to do if your eyes are bulging?

Protruding eyes are a disease that will cause vision problems for the patient. As the disease worsens, the duration of the disease will also increase. Protruding eyes are a disease that can only be treated through surgery, and if you suffer from this disease you must protect the exposed cornea.

1. Inspection

For unexplained unilateral exophthalmos, thyroid function tests should be done. If thyroid function is normal or the exophthalmos is sudden, orbital CT scan or MRI should be done to look for intraorbital causes. The degree of exophthalmos can be measured with an exophthalmometer.

2. Diagnosis

1. Temporary exophthalmos

It is an important feature of this disease. Its prominence may increase or decrease with changes in the head position, and its duration may vary. It may occur frequently or occasionally. When the patient lowers his head, exhales forcefully, compresses the jugular vein or twists his neck to the side, it can cause temporary exophthalmos, and also show: ptosis, eyelid swelling, conjunctival congestion and edema, pupil dilation, retinal varicose veins, blurred optic disc boundaries, eye movement disorders and increased intraocular pressure.

2. During an attack

There is a feeling of tension in the eyes, occasional double vision and temporary visual impairment, as well as systemic symptoms such as dizziness, headache, nausea, vomiting and tinnitus, or dilation of the ipsilateral temporal and facial veins.

3. After the attack

The eyeball returns to its original position and all the above symptoms disappear, but the eyeball often appears sunken due to vascular dilation and atrophy of the orbital fat tissue caused by long-term compression.

Treatment

Treatment depends on the cause and is mainly surgery. Treatment of arteriovenous aneurysms should include ligation of the affected common carotid artery. Exophthalmos caused by hyperthyroidism may subside after the hyperthyroidism is controlled. Occasionally, stubborn cases require orbital decompression surgery.

The exposed cornea must be protected when the eyeball is exophthalmos. Exposure keratitis is common with proptosis caused by the thyroid gland. Systemic corticosteroids often help control edema and pseudotumors (eg, oral prednisone tapered to the lowest dose that controls proptosis); tumors must be removed.