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Congenital Exophthalmos


Presentation

  • Individual case presentations provide a valuable tool for differential diagnosis.[books.google.com]
  • 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]
  • It presents with acute, usually unilateral proptosis with severe pain.[oculoplastic-eyelid-orbit-surgery.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]
Inflammation
  • The contents of the orbits swell due to inflammation, forcing the eyes forward. The inflammation affects primarily the muscles.[medical-dictionary.thefreedictionary.com]
  • If mom cat was predisposed to toxic compounds, certain systemic infections or inflammations or poor nutrition during pregnancy, her kittens have an increased risk of eye disorders.[pets.thenest.com]
  • […] of the sinus) congenital absence of the orbital wall (the classical type is absence of sphenoid wing in neurofibromatosis) Cicatricial changes (this causes traction of the globe) metastatic tumours (classically breast carcinoma) post-inflammation (such[mrcophth.com]
  • Dacryoadenitis – Inflammation of the lacrimal glands (tear glands) Mucormycosis – A kind of Orbital Fungal infection Orbital pseudotumor – A non-specific orbital soft tissue inflammation (swelling), that involves any area of the orbit.[oculoplastic-eyelid-orbit-surgery.com]
  • Orbital and lid inflammation and minimal exophthalmos may occur after trauma to a dermoid tumor that has caused extrusion of its contents.[medigoo.com]
Swelling
  • The contents of the orbits swell due to inflammation, forcing the eyes forward. The inflammation affects primarily the muscles.[medical-dictionary.thefreedictionary.com]
  • 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]
  • Since that time he has also noticed a gradual bulging of the right eye and increasing puffiness and swelling over the right lower lid which increased slightly on exertion and on bending forwards.[ijo.in]
  • However, pain, diplopia, swelling, tearing and blurred vision are much more common presenting complaints.[medigoo.com]
  • Complete or partial dislocation from the orbit is also possible from trauma or swelling of surrounding tissue resulting from trauma.[findwords.info]
Goiter
  • Exophthalmos and goiter in Graves' disease.[medical-dictionary.thefreedictionary.com]
  • Goiter is an enlarged thyroid gland and is of the diffuse type (i.e., spread throughout the gland). Diffuse goiter might be seen with other causes of hyperthyroidism, although Graves' disease is the most common cause of diffuse goiter.[eyeplastics.com]
  • Goiter is an enlarged thyroid gland and is of the diffuse type (i.e., spread throughout the gland). Diffuse goiter may possibly be seen with other causes of hyperthyroidism, although Graves' disease is the most common cause of diffuse goiter.[drmansueto.com]
  • […] manifestations of Graves disease thyroid acropachy : occurs in 1% 7 Graves ophthalmopathy or orbitopathy: affects 20-25% of cases encephalopathy associated with autoimmune thyroid disease (EAATD) 2, 8 The combination of exophthalmos, tachycardia, and goiter[radiopaedia.org]
  • Symptoms and Signs In infants, symptoms and signs of hyperthyroidism include irritability, feeding problems, hypertension, tachycardia, exophthalmos, goiter (see Congenital Goiter ), frontal bossing, and microcephaly.[merckmanuals.com]
Anemia
  • New chapters, expanded and updated coverage, increased worldwide perspectives, and many new contributors keep you current on the late preterm infant, the fetal origins of adult disease, neonatal anemia, genetic disorders, and more. "...a valuable reference[books.google.com]
  • […] to the overproduction of thyroid hormone type II hypersensitivity pituitary TSH is suppressed via negative feedback from elevated thyroid hormone Genetics HLA-DRB1 and HLA-DQB1 PTNP22 Associated conditions polyglandular autoimmune syndrome pernicious anemia[medbullets.com]
Thrombosis
  • […] 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]
  • 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]
  • 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]
Fracture
  • It implies that the globe itself is normal and is caused by either one or a combination of 1 : structural alterations in the bony orbit orbital fat atrophy retraction Specific causes include 2 : orbital blowout fracture : most common silent sinus syndrome[radiopaedia.org]
  • The most common cases in the examination are orbital floor fracture and small globes of various causes) Apparent or pseudo-enophthalmos Horner's syndrome (due to narrowing of the palpebral fissure) Muscle resection Increased in the volume of the orbit[mrcophth.com]
  • Wall Orbital Fracture Orbital Cellulitis Orbital Dermoid Pediatric Mucormycosis Sphenoid Wing Meningioma Thyroid Ophthalmopathy Zygomatic Complex Fractures medical-dictionary.thefreedictionary.com.[emedicine.medscape.com]
  • 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 (eyelid cannot close) Orbital Fracture[health.ucsd.edu]
  • Orbital arterio-venous malformation (carotico-cavernous sinus fistula) Cystic: Dermoid cyst Others: Orbital fractures: apex, floor, medial wall, zygomatic Retrobulbar hemorrhage: trauma to the orbit leading to bleeding behind the eye.[oculoplastic-eyelid-orbit-surgery.com]
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]
Hydrops Fetalis
  • Stay at the forefront of your field thanks to new and completely revised chapters covering topics such as: Principles and Practice l Immune and Non-immune Hydrops Fetalis l Amniotic Fluid Volume l Enhancing Safe Prescribing in the Neonatal Intensive Care[books.google.com]
Enophthalmos
  • See pathological diplopia ; Graves' disease ; elephantiasis oculi ; enophthalmos ; Apert's syndrome ; Crouzon's syndrome. Fig. E7 Severe bilateral exophthalmos and lid retraction in Graves' disease.[medical-dictionary.thefreedictionary.com]
  • Enophthalmos (This is the backward displacement of the globe into the orbit.[mrcophth.com]
  • Enophthalmos refers to the posterior displacement of the globe in the orbit.[radiopaedia.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]
  • 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]
Diplopia
  • See pathological diplopia ; Graves' disease ; elephantiasis oculi ; enophthalmos ; Apert's syndrome ; Crouzon's syndrome. Fig. E7 Severe bilateral exophthalmos and lid retraction in Graves' disease.[medical-dictionary.thefreedictionary.com]
  • The most frequent surgical case that can result in diplopia is cataract surgery. 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]
  • 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]
  • There was no history of fever, vomiting, trauma or diplopia. On examination there was a boggy swelling towards the medial side of the lower lid 3 cms x 3 cms with greenish-black discolouration over the skin and upper and lower fornices.[ijo.in]
Strabismus
  • 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]
  • Recently acquired diplopia in adults with long-standing strabismus. Arch Ophthalmol 2001 Dec; 119(12):1795-801. 3. Brazis PW, Lee AG. Acquired binocular horizontal diplopia. Mayo Clin Proc 1999 Sep;74(9):907-16. 4. Kushner BJ.[reviewofoptometry.com]
Strabismus
  • 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]
  • Recently acquired diplopia in adults with long-standing strabismus. Arch Ophthalmol 2001 Dec; 119(12):1795-801. 3. Brazis PW, Lee AG. Acquired binocular horizontal diplopia. Mayo Clin Proc 1999 Sep;74(9):907-16. 4. Kushner BJ.[reviewofoptometry.com]
Bilateral Proptosis
  • 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]
  • This might explain why one autoantibody to the TSHr can cause disease in both the thyroid and the eyes Lid Retraction Proptosis Graves Disease Grave's Ophthalmolopathy is the most common caused of unilateral or bilateral proptosis in adults.[eyeplastics.com]
  • This may possibly explain why one autoantibody to the TSHr can cause disease in both the thyroid and the eyes Lid Retraction Proptosis Graves Disease Grave's Ophthalmolopathy is the most common caused of unilateral or bilateral proptosis in adults.[drmansueto.com]

Treatment

  • Features coverage of the latest treatment innovations including antibiotic residue testing, care of individual metabolic disease, troubleshooting, and much more.[books.google.com]
  • Make informed clinical choices for each patient, from diagnosis and treatment selection through post-treatment strategies and management of complications, with new evidence-based criteria throughout.[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

  • 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]
  • 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 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

  • 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]
  • […] 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]
  • 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]
  • 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]

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]
Sex distribution
Age distribution

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]

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]

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