Q: What should I do if my eyeballs protrude?

Answer: Due to various reasons, the eyeball shifts forward and the apex of the cornea exceeds the supraorbital rim, which is called proptosis. Normal people's exophthalmos is generally 12-14 mm, and the difference between the eyes is less than 2 mm. If the exophthalmos exceeds 16 mm, and the difference between the eyes is more than 2 mm, it can be considered as exophthalmos. There are many causes of exophthalmos. If you find that there is exophthalmos, you should actively search for the cause to get effective treatment. The common causes are as follows:

(1) Inflammatory exophthalmos is often caused by local, nearby Caused by tissue and systemic inflammation, including eyeball fasciitis, orbital cellulitis, cavernous sinus thrombosis, panophthalmitis, etc. In addition to protruding eyeballs, the symptoms also include local inflammation such as redness, swelling, heat, and pain.

(2) Intraorbital tumors are one of the common causes of exophthalmos; they are mostly benign, with hemangioma being the most common, with slow onset and mainly manifested as exophthalmos, normal or decreased vision, and excessive eye movements. Barrier-free, common tumors include hemangiomas, meningiomas, lacrimal gland tumors, nerve sheath tumors, etc.; malignant tumors include leiomyoma, etc.

(3) Vascular proptosis is more common in cavernous sinus leakage of the internal carotid artery; orbital varicose veins. The former is more common after trauma. One or both eyes bulge, and there is a pulsating sensation. A rumbling sound can be heard on auscultation, which compresses the internal carotid artery. The proptosis and pulsation can disappear, so it can be called pulsatile proptosis. The latter can be called pulsatile proptosis. It is congenital or acquired. When the patient lowers his head or holds his breath, exophthalmos occurs. When the head is upright or lying on the back, the eyeball can recover, so it is called intermittent exophthalmos. Mainly due to congestion and stasis of intraorbital veins.

(4) Orbital bone deformity and exophthalmos. Due to various reasons, the orbital bone is deformed, which reduces the volume of the orbit and causes exophthalmos. It is more common in congenital apex deformity, congenital ectopic sphenoid wing, hydrocephalus, etc.

(5) Traumatic exophthalmos is caused by intraorbital hemorrhage, tissue edema, and emphysema after local trauma to the eye and orbit.

(6) Thyroid exophthalmos mostly occurs in women, with moderate protrusion of both eyes, and may be accompanied by enlarged palpebral fissures, decreased blinking, etc. At the same time, there are symptoms of hyperthyroidism throughout the body.

(7) Pituitary exophthalmos is more common in middle-aged men. It occurs in both eyes and can occur one after another. It is progressive exophthalmos, so it is also called malignant exophthalmos, eyelid edema, exposed bulbar conjunctival edema, and eye movement. Obstruction, the eyelids cannot close, and corneal damage is prone to occur.

(8) Other exophthalmos: Intraorbital parasitic exophthalmos, local retrobulbar paralysis accident, exophthalmos, Hodgkin's disease, etc. may occur.

(9) Pseudophthalmos is more common in high myopia, corneal staphyloma, bull's eye, etc. It looks like proptosis due to the long axial length of the eye. After the occurrence of proptosis, a systemic examination is first performed to rule out proptosis caused by the whole body. At the same time, further imaging examinations such as B-ultrasound, CT, and magnetic resonance imaging are performed to confirm the diagnosis; in treatment, if it is inflammatory proptosis, local treatment is required. And systemic antibiotic treatment can subside the inflammation, and if the local tumor has obvious proptosis and vision is affected, surgical treatment can be considered. Vascular exophthalmos can be treated with vascular embolization, which can achieve good results: Endocrine exophthalmos can be treated with oral drugs for systemic treatment of hyperthyroidism, etc. , in short, the treatment of exophthalmos must be targeted and fundamentally remove the cause, so as to relieve the symptoms of exophthalmos.