Proptosis

Causes

What causes proptosis can vary from one person to another. Proptosis can be a symptom of these common conditions, among others:

• Thyroid disease (Graves disease): Graves disease is the most common cause of proptosis. It’s an autoimmune disease that leads to hyperactive thyroid function and causes the tissue around the eye to become inflamed and swollen.
• Orbital tumors: Tumors inside the eye socket can push the eye forward and out of position.
• Orbital cellulitis: This is a bacterial infection most common in children that irritates and causes swelling of the eye tissues.
• Vascular abnormalities: Malformed or restricted blood flow in blood vessels within the eye can also lead to ocular swelling and proptosis.
• Traumatic injuries: Physical trauma, including fractures or significant bruising and swelling, can cause the eye to become misaligned and protrude out of its usual place in the socket.

Symptoms

The main symptom of proptosis is the bulging of one or both eyes, with increased visibility of the white portion of your eye and sometimes decreased visibility of the upper eyelid. You may also notice any of the following symptoms:

• Difficulty blinking
• Red or irritated eyes
• Swelling and irritation of the eyelids
• Blurred, restricted, or double vision
• Dry eyes or excessive tearing
• Eye pain
• Reduced eye movements
• Light sensitivity
• Headache
• Fever

Diagnosis

If you notice any swelling or bulging of your eye, you should seek medical attention right away for a diagnosis and treatment plan.

Diagnosis of proptosis is twofold. Your eye doctor or medical doctor will be able to identify the protrusion of your eye through measurements and comparison of the angles involving the bony eye socket (orbit) and the position of the cornea. They will also assess your eye and eyelid movements.

Additional tests may include:

• A slit lamp exam to examine eye structures
• CT or MRI to measure the severity of the bulging and look for underlying causes
• Thyroid function testing if Graves disease is suspected
• Cultures and blood tests to help identify the causes and nature of infections

Treatment Options

In general, the first line of treatment for proptosis is the use of eye drops and lubrication to help reduce swelling. Additional treatment options for proptosis depend on the underlying condition and may include the following:

• Thyroid eye disease: Appropriate thyroid medications, corticosteroids, immunosuppressants, or surgery
• Tumor: Surgery, radiation, or other cancer treatment options
• Infection: Topical and/or oral antibiotics
• Trauma: Anti-inflammatory treatments, including steroids, and reconstruction surgery if needed
• Blood flow restrictions: Topical treatments or surgical interventions

With proper treatment, it’s often possible for the protruding appearance of your eye to return to normal. However, it will take time to reverse the problem. Because of the highly visible and prolonged nature of proptosis, it may also be advisable to seek counseling or other support to help you cope with this condition.

Don’t delay getting the care you need to maintain your vision health. Schedule your yearly eye exam through Visionworks today.