The left eyeball protrudes more than the right eyeball

People's eyeballs are divided into many varieties. Because of different development and family genetics, each person's facial features are slightly different. When the left eyeball protrudes more than the right eyeball, if you feel abnormal symptoms, you should consider whether it is a neurological disorder or other disease factors that cause the eyeball to protrude.

Common diseases

Acute orbital cellulitis, panophthalmitis, orbital periostitis, suppurative tenon's fasciitis, cavernous sinus thrombosis, inflammatory pseudotumor, syphilis, tuberculosis, hemangioma, dermoid cyst, meningioma, neurilemoma, optic nerve glioma, lymphoma, lacrimal gland tumor, rhabdomyosarcoma, orbital wall osteoma, retinoblastoma, choroidal malignant melanoma, eyelid, conjunctival squamous cell carcinoma, eyelid basal cell carcinoma, malignant melanoma, meibomian gland carcinoma, orbital and cavernous sinus arteriovenous fistula, orbital varicose veins, endocrine exophthalmos, orbital bone fracture, orbital hematoma, Crouzon syndrome, Gruber syndrome, Apert syndrome.

diagnosis

Ask in detail about the medical history, onset time, whether there was redness or pain in the eyes at the beginning, the location of the redness and pain, and its relationship with the exophthalmos. Exophthalmos can develop rapidly or slowly. Unilateral or bilateral. If there is a history of trauma, especially head trauma, the possibility of arteriovenous fistula should be considered.

Differential Diagnosis

1. Inflammatory exophthalmos

1. Orbital cellulitis: It is an acute inflammation of the orbital soft tissue or under the periosteum. Due to the close relationship between the orbit, cranial cavity and eyeball, it may cause permanent visual impairment and intracranial complications. It is mostly caused by the spread of infection from adjacent tissues or traumatic infection. Clinical manifestations include proptosis and movement disorders. There are also redness and swelling of the eyelids, conjunctival congestion and edema, and the fundus may have optic disc congestion, edema, and retinal edema. In severe cases, the body temperature increases and the white blood cell count increases. Due to the cardiac reflex, a relatively slow pulse may occur.

2. Inflammatory pseudotumor: It is one of the common causes of unilateral exophthalmos. Because it has symptoms of a tumor, but is essentially a nonspecific chronic proliferative inflammation in the orbit, it is called an inflammatory pseudotumor. Clinical manifestations: There is a history of eyelid redness and swelling, and proptosis or eyelid mass is discovered weeks or months later. Some patients often cannot remember the history of eyelid redness and swelling. Some patients have a characteristic sign of a sunken groove along the orbital rim due to contraction of scars deep in the orbit. There may be pain, diplopia, decreased vision, and conjunctival congestion and edema. Pseudotumor and severe endocrine exophthalmos both have similarities in that their orbital tissues show congestive and infiltrative changes. However, upper eyelid retraction and abnormal thyroid function test are the key points for diagnosis of endocrine exophthalmos.