Exophthalmos
Exophthalmos (Proptosis)
Introduction
Exophthalmos is a medical condition in which one or both eyes bulge or protrude out of the eye sockets (orbits). It is not a disease itself but a symptom of an underlying problem. It can be mild or very serious, depending on the cause.
Definition
Exophthalmos (also called proptosis) is the forward displacement of the eyeball beyond the normal position.
Causes of Exophthalmos
There are many reasons why eyes can bulge. The most common causes are:
Endocrine Causes Graves’ Disease (Hyperthyroidism): Most common cause. The immune system attacks the tissues behind the eyes, causing swelling. Infections Orbital cellulitis (infection in the tissues around the eye). Tumors in the Orbit Benign or malignant growths in the eye socket. Trauma Injury causing bleeding or swelling behind the eye. Other Causes Vascular malformations (like carotid-cavernous fistula). Inflammatory conditions (like orbital pseudotumor).
Signs and Symptoms
Forward bulging of one or both eyes. Redness of eyes. Pain or pressure around eyes. Difficulty closing eyelids completely. Dry eyes or excessive tearing. Double vision (diplopia). In severe cases → vision loss due to pressure on the optic nerve.
Diagnosis
To find the exact cause, doctors may use:
Medical History & Examination – checking for thyroid problems, infections, or injuries. Exophthalmometer – an instrument to measure how much the eye is bulging. Blood Tests – to check thyroid function. Imaging – CT scan or MRI of orbit.
Treatment
Treatment depends on the cause:
Graves’ Disease (Hyperthyroidism) Antithyroid drugs, radioiodine therapy, or surgery. Steroids may be used to reduce inflammation. Infections (Orbital Cellulitis) Strong antibiotics. Sometimes surgery to drain pus. Tumors Surgery, radiation, or chemotherapy depending on type. Symptomatic Treatment Lubricating eye drops (to prevent dryness). Eye patches (for double vision). In severe cases → orbital decompression surgery (removing bone to reduce pressure).
Complications
If untreated, exophthalmos can lead to:
Corneal ulcers (due to dryness). Permanent vision loss (due to optic nerve damage). Cosmetic problems (appearance changes).
Nursing Care and Management
Monitor eye condition regularly. Provide lubricating eye drops to prevent dryness. Educate patient about thyroid disease (if present). Advise wearing sunglasses to protect eyes. Supportive counseling for cosmetic or psychological concerns.
Conclusion
Exophthalmos is an important eye condition where the eyeball protrudes outward. The most common cause is Graves’ disease, but infections, tumors, and trauma may also be responsible. Early diagnosis and treatment are necessary to prevent vision loss and complications. Nurses and healthcare providers play a vital role in eye care, patient education, and emotional support.