Presentation
Individual case presentations provide a valuable tool for differential diagnosis. [books.google.com]
Presentation : these variably present from early childhood (especially lymphangiomas) to adulthood. Varices present with intermittent proptosis (evident in the Valsalva manoeuvre) ± visible lesions in the eyelid. [patient.info]
More than 95% of children born to mothers with Graves disease present with symptoms within the first month of life; rarely, presentation is delayed into the second month. [merckmanuals.com]
Snapshot A 27-year-old woman with vitiligo presents to her primary care physician with progressive fatigue and weight loss despite a good appetite. [medbullets.com]
Is the diplopia present at distance, near or both? Many diagnoses can be ruled out if the diplopia is present only at a certain distance. [reviewofoptometry.com]
Entire Body System
- Camping
The mutation of family 1, as a somatic point mutation leading to autonomous thyroid adenoma, has originally been demonstrated to constitutively activate TSH independent cAMP accumulation. [thieme-connect.com]
Cardiovascular
- Thrombosis
Bio-electric phenomena as an etiologic factor in intravascular thrombosis. Am. J. Physiol. 1953 175 : 103 – 107. Sawyer P. N. and Pate J. W. Bio-electric phenomena as an etiologic factor in intravascular thrombosis. Am. J. [thejns.org]
Inflammatory conditions: Mikulicz’s syndrome and late stage of cavernous sinus thrombosis. 4. Endocrinal exophthalmos: It may be thyrotoxic or thyrotropic. 5. [ikeyes.blogspot.com]
[…] characteristic of hyperthyroidism or thyrotoxicosis exophthalmos Abnormal protrusion of the eyeball(s) from the orbit, caused by Graves' ophthalmopathy, endocrine malfunction, paralysis of the extraocular muscles, injury of the orbit, cavernous sinus thrombosis [medical-dictionary.thefreedictionary.com]
Bilateral proptosis in adults is caused most often by TED; however, bilateral orbital involvement from lymphoma, vasculitis, NSOI, metastatic tumors, carotid cavernous fistulas, cavernous sinus thrombosis, or leukemic infiltrates can also produce bilateral [aao.org]
This condition occurs in people who have an aneurysm of the orbit or suffering from thrombosis of the cavernous sinus. Separately, you should pay attention to a pathology such as edematous exophthalmos. [brulanta.com]
- Vascular Disease
Cavernous Hemagioma – A vascular tumor. Lymphoma Orbital Vascular Disease: Orbital varix – a thin walled arterio-venous tumor (Blood vessel tumor), enlarged abnormally, that is in direct communication with the normal vessels of the orbit. [oculoplastic-eyelid-orbit-surgery.com]
Exophthalmos is a sign of orbital tumor but can also be caused by other conditions such as thyroid disease, orbital varix, arteriovenous fistula, collagen vascular disease, infections, pseudotumor, prolapse of cranial contents into the orbit and congenital [medigoo.com]
It is an INO plus, hence the name one-and-a-half syndrome. 3,19-24 Both INO and one-and-a-half syndrome are most commonly acquired secondary to multiple sclerosis, tumor, or vascular disease. 5 Convergence insufficiency, by definition, is primarily characterized [reviewofoptometry.com]
Skin
- Macula
Fundus showed normal disc arteries and macula. Movements of the eye in the up and in direction were restricted. An orbitovenogram on the right side was performed. [ijo.in]
Distortion of the macula by a lesion pushing in behind the globe. Exposure keratopathy (see above) can also affect the visual acuity. [patient.info]
- Erythema
Sugasawa J, Shimakawa S, Ogihara T, Okamoto N, Ikeda T Case reports in ophthalmology 9(1) 102-107 Jan 2018 [Refereed] C-reactive protein may be useful to differentiate idiopathic orbital inflammation and orbital cellulitis in cases with acute eyelid erythema [researchmap.jp]
Eyes
- Enophthalmos
Enophthalmos (This is the backward displacement of the globe into the orbit. [mrcophth.com]
An asymmetry of greater than 2 mm between an individual patient’s eyes suggests proptosis or enophthalmos. [aao.org]
Enophthalmos has the opposite effect, causing the eye to sink into the skull. Viral and Bacterial Infections Pesky organisms can wreak havoc on your beloved kitten’s eyes. [pets.thenest.com]
Enophthalmos refers to the posterior displacement of the globe in the orbit. [radiopaedia.org]
Ophthalmic Pathology Ophthalmic Plastic & Reconstructive Surgery Aging Face Anophthalmos Asian Eyelid Enhancement Baggy or Puffy Eyes Blind and Painful Eye Blocked Tear Duct Cosmetic Eyelid Craniofacial Syndrome Dermatochalasis Drooping Eyelid Ectropion Enophthalmos [health.ucsd.edu]
- Strabismus
Research of Exophthalmos Congenital has been linked to Exophthalmos, Orbital Neoplasms, Neoplasms, Teratoma, Strabismus. [novusbio.com]
Strabismus — Any deviation of the eyes from a common direction. Commonly called a turned eye. [medical-dictionary.thefreedictionary.com]
Abnormal Eyeball Positioning If your kitten’s eyeball appears abnormally positioned, he may have strabismus, exophthalmos or enophthalmos. Strabismus occurs when one or both eyes look off in different directions, often referred to as crossed eyes. [pets.thenest.com]
Lagophthalmos (eyelid cannot close) Orbital Fracture(s) Orbital Tumors Ptosis Revisional Eyelid Surgery Stye (Chalazion) Optometry & Low Vision Pediatric Ophthalmology & Eye Alignment Disorders Accommodative Esotropia Amblyopia Eye Movement Disorders Strabismus [health.ucsd.edu]
Practical Ophthalmology 58 2000 Chiasmal syndrome New J Mustrated Hand book of Clinical Ophthalmology 8 1999 Intranuclear ophthalmoplegia Practical Ophthalmology 43 1999 Nystogmus Practical Ophthalmology 1997 Research Grants & Projects Plain Text Study on strabismus [researchmap.jp]
- Bilateral Proptosis
Bilateral proptosis in adults is caused most often by TED; however, bilateral orbital involvement from lymphoma, vasculitis, NSOI, metastatic tumors, carotid cavernous fistulas, cavernous sinus thrombosis, or leukemic infiltrates can also produce bilateral [aao.org]
CLASSIFICATION Proptosis can be divided into following clinical groups: Unilateral proptosis Bilateral proptosis Acute proptosis Intermittent proptosis Pulsating proptosis ETIOLOGY Important causes of proptosis in each clinical group are listed here: [ikeyes.blogspot.com]
Etiology / Causes of Proptosis: Inflammatory/Infection: Graves’ ophthalmopathy, due to Graves’ disease (Thyroid Eye Disease), usually causes bilateral proptosis. Orbital cellulitis – Infection of the orbit. [oculoplastic-eyelid-orbit-surgery.com]
Another tumour affecting the orbit and so resulting in proptosis is granulocytic sarcoma (chloroma) which may present with rapid onset of (occasionally bilateral) proptosis at about 7 years of age. [patient.info]
(min 28) 4 EOM involved 5 Corneal involvement 6 Sight loss Symptom Type I Type II Sex predilection Female Proptosis Symmetric Unilateral or bilateral Eyelid retraction Symmetric Unilateral or bilateral Orbital inflammation Minimal Extraocular muscle [eyeplastics.com]
- Chemosis
It is often grouped into two independent manifestations of this syndrome: Type I and Type II orbitapathy, but might overlap More frequent signs: Less frequent signs: lid lag (upper and lower) exophthalmos diplopia lid edema chemosis conj injection over [eyeplastics.com]
It is often grouped into two independent manifestations of this syndrome: Type I and Type II orbitapathy, but may possibly overlap More frequent signs: Less frequent signs: lid lag (upper and lower) exophthalmos diplopia lid edema chemosis conj injection [drmansueto.com]
Conjunctival chemosis. Flushing noise in the head. Management issues : most fistulae are sight-threatening rather than life-threatening. [patient.info]
A slight degree of exophthalmos of about 1 to 2 mm may occur in a total third nerve palsy.In cases of bilateral exophthalmos, particularly if there is no fever or chemosis or ecchymosis, a thyroid profile is the most valuable test. [medigoo.com]
[…] the upper eyelid lags behind Enroth’s sign: fullness of the eyelids due to puffy edematous swelling Gifford’s sign: difficulty in eversion of the upper eyelid Stellwag’s sign: infrequent and incomplete blinking Conjunctival signs: deep injection and chemosis [clinipedia.wordpress.com]
- Lagophthalmos
Lastly, look for lagophthalmos. Lagophthalmos is the inability to close the eyes completely. It causes complications like corneal abrasion and infection, corneal drying and ulceration. ii. Palpation The next step is palpation. Check for pulsatility. [clinipedia.wordpress.com]
Eyelid Enhancement Baggy or Puffy Eyes Blind and Painful Eye Blocked Tear Duct Cosmetic Eyelid Craniofacial Syndrome Dermatochalasis Drooping Eyelid Ectropion Enophthalmos Exophthalmos Eyelid Lesions/Bumps Eyelid Retraction Eyelid Tumors Eyelid Wrinkles Lagophthalmos [health.ucsd.edu]
Conservative treatment is of prime importance since meddlesome operative intervention may produce severe orbital haemorrhage, followed by proptosis, lagophthalmos and corneal ulceration. [ijo.in]
Examination: the orbit - look for lid swelling, engorged conjunctival and episcleral vessels and lagophthalmos/incomplete lid closure. Palpate the orbit for any tenderness or masses and examine the regional lymph nodes. [medigoo.com]
The orbit Look for lid swelling, engorged conjunctival and episcleral vessels and lagophthalmos/incomplete lid closure. Palpate the orbit for any tenderness or masses and examine the regional lymph nodes. [patient.info]
Treatment
Features coverage of the latest treatment innovations including antibiotic residue testing, care of individual metabolic disease, troubleshooting, and much more. [books.google.com]
Treatment If a tumor is growing behind the eye, it needs to be removed. If Graves' disease is the cause, it may subside with treatment of the overactive thyroid, but this is not guaranteed. [medical-dictionary.thefreedictionary.com]
& Medications Thyrogen Treatment – Thyroid Cancer Thyrogen FAQs Nexavar Treatment – Thyroid Cancer Radioactive Iodine – To Treat the Thyroid Gland Surgery – Hemi Thyroidectomy – Total Thyroidectomy Hyperthyroidism/OveractiveThyroid Hypothyroidism/Underactive [thyroidfoundation.org.au]
Birthmarks are very common and most types do not require any treatment at all. [gosh.nhs.uk]
Prognosis
Surgical outcomes with 360-degree suture trabeculotomy in poor-prognosis primary congenital glaucoma and glaucoma associated with congenital anomalies or cataract surgery. [freethesaurus.com]
Prognosis Exophthalmos can be progressive. Its progress must be carefully followed, treating complications as they occur. Prevention Vision can usually be preserved with attentive treatment. [medical-dictionary.thefreedictionary.com]
PATOLOGIA NEOPLASTICA min. max. fisso 9322 NEOPLASIE A PROGNOSI FAVOREVOLE CON MODESTA COMPROMISSIONE FUNZIONALE / / 11 9323 NEOPLASIE A PROGNOSI FAVOREVOLE CON GRAVE COMPROMISSIONE FUNZIONALE / / 70 9325 NEOPLASIE A PROGNOSI INFAUSTA O PROBABILMENTE [medisoc.it]
Prognosis of ocular myasthenia. Ann Neurol 1983 Nov;14(5):516-9. 17. Weinberg DA, Lesser RL, Vollmer TL. Ocular myasthenia: a protean disorder. Surv Ophthalmol 1994 Nov-Dec;39(3):169-210. 18. Kanski JJ. Clinical Ophthalmology, 4th ed. [reviewofoptometry.com]
Etiology
Otorhinolaryngological examination is necessary when the paranasal sinus or a nasopharyngeal mass apears to be a possible etiological factor. II. [ikeyes.blogspot.com]
[…] thyroid enlargement myxedema dermal accumulation of mucopolysaccharides non-pitting hyperreflexia Studies Diagnostic testing diagnostic approach screening for patients with clinical suspicion autoantibody titers are diagnostic imaging to differentiate etiologies [medbullets.com]
Etiology / Causes of Proptosis: Inflammatory/Infection: Graves’ ophthalmopathy, due to Graves’ disease (Thyroid Eye Disease), usually causes bilateral proptosis. Orbital cellulitis – Infection of the orbit. [oculoplastic-eyelid-orbit-surgery.com]
The etiology of the thyroid-related orbitopathy is an autoimmune process, predominantly affecting the fat and the extraocular muscles. There is accompanying accumulation of glycosaminoglycans and water. [clinipedia.wordpress.com]
[…] interstitial and granulonodulo alveolar pattern 324 Interstitialreticular pulmonary pattern 326 Disseminated interstitial pneumonitis 327 The miliary pattern of pneumonia 328 Short linear andor wedgeshaped densities 329 Pulmonary edema in infancy and childhood Etiology [books.google.com]
Epidemiology
Epidemiology and prevention of Graves' ophthalmopathy. Thyroid. 2002 Oct. 12(10):855-60. [Medline]. Putta-Manohar S, Perros P. Epidemiology of Graves' orbitopathy. Pediatr Endocrinol Rev. 2010 Mar. 7 Suppl 2:182-5. [Medline]. [emedicine.medscape.com]
Introduction Clinical definition autoimmune hyperthyroidism Epidemiology demographics the most common cause of hyperthyroidism in the United States female dominant typically 20-40 years of age Pathogenesis triggered by stress e.g. childbirth, infection [medbullets.com]
The epidemiologic characteristics and clinical course of ophthalmopathy associated with autoimmune thyroid disease in Olmsted County, Minnesota. Trans Am Ophthalmol Soc 1994;92:477-588. 8. Brazis PW, Lee AG. Binocular vertical diplopia. [reviewofoptometry.com]
Pathophysiology
PATHOPHYSIOLOGY OF EXOPHTHALMOS There is a small amount of redundant space within the orbit and so any swelling within these tissues results in forward displacement of the globe. [clinipedia.wordpress.com]
The pathophysiology of thyroid eye disease: implications for immunotherapy. Curr Opin Ophthalmol. 2011 Sep. 22 (5):385-90. [Medline]. Ugradar S, Rootman DB. Case Series: Noninflammatory Thyroid Eye Disease. [emedicine.medscape.com]
Decreased vision - visual acuity may be impaired by: Direct optic nerve involvement due to the pathophysiology. Distortion of the macula by a lesion pushing in behind the globe. Exposure keratopathy (see above) can also affect the visual acuity. [patient.info]
Prevention
Revised drug usage recommendations and legal considerations present the most current information in these critical areas to help you prevent dangerous or costly errors. [books.google.com]
Prevention Vision can usually be preserved with attentive treatment. There is currently no way to prevent any of the underlying conditions that lead to exophthalmos. Resources Books Fauci, Anthony S., et al., editors. [medical-dictionary.thefreedictionary.com]
Early detection and treatment could prevent vision loss. See an eye care professional right away if you have a sudden change in vision, if everything looks dim, or if you see flashes of light. [icdlist.com]
Hyperthyroidism can cause exophthalmos How can it be prevented? In some cases, in its initial stages, exophthalmos can only be detected using imaging techniques. [imo.es]
Medicine and medications: Ocular lubricants: Keep adequate moisture in eye and prevent dryness.Artificial tears (Celluvisc, Murine, Refresh, Tears Naturale). [medigoo.com]