What causes protruding eyeballs

We need to pay attention to the problem of exophthalmos, because exophthalmos may be caused by some systemic inflammation, such as arthritis, fasciitis, or orbital cellulitis, etc., which may be the reasons, so symptomatic treatment is required.

(1) Inflammatory exophthalmos is mostly caused by local, adjacent tissue and systemic inflammation, such as eye fasciitis, orbital cellulitis, cavernous sinus thrombosis, panophthalmitis, etc. In addition to bulging eyes, there are also signs of inflammation such as local redness, swelling, heat, and pain.

(2) Orbital tumors are one of the common causes of exophthalmos. Most of them are benign, with hemangiomas being the majority. They develop slowly and are characterized by protrusion of the eyeball, normal or decreased vision, and unimpeded eye movement. Common tumors include hemangiomas, meningiomas, lacrimal gland tumors, and neurotheca tumors. Malignant tumors include leiomyoma, etc.

(3) Vascular proptosis is often seen in carotid cavernous sinus fistula and orbital varicose veins. The former is more common after trauma, with bulging of one or both eyes, a pulsating feeling when touched, and a rumbling sound when auscultated. The exophthalmos and pulsation may disappear when the internal carotid artery is compressed, so it is called pulsating exophthalmos. The latter may be congenital or acquired, and the eyeball may bulge when the person lowers his head or holds his breath. The eyeball may recover when the head is upright or lying on his back, so it is called intermittent exophthalmos. It is mainly caused by congestion of the orbital veins.

(4) Exophthalmos due to orbital deformity: Due to various reasons, the orbital bones are deformed, which reduces the volume of the orbital contents and causes protrusion of the eyeball. It is common in congenital acrocephaly, congenital ectopia of the greater wing of the sphenoid bone, hydrocephalus, etc.

(5) Traumatic exophthalmos is caused by local trauma to the eye or orbit, resulting in orbital hemorrhage, tissue edema, and emphysema.

(6) Thyroid exophthalmos mostly occurs in women, with both eyes showing moderate protrusion of the eyeballs, 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 affects both eyes and can occur one after the other. It is a progressive protrusion of the eyeball, so it is also called malignant exophthalmos. The eyelids are swollen, the conjunctiva is exposed, the eye movement is impaired, the eyelids cannot close, and corneal damage is prone to occur.