What is Proptosis?
Proptosis, also known as exophthalmos, is the abnormal protrusion or bulging of one or both eyes from the eye socket (orbit). It can be a sign of an underlying medical condition, ranging from inflammatory disorders to tumors or thyroid disease. When left untreated, proptosis may lead to vision problems or damage to the eye.
What causes Proptosis?
Proptosis can result from several causes, including:
- Thyroid eye disease (Graves’ orbitopathy) – the most common cause
- Orbital tumors – benign or malignant growths behind the eye
- Orbital cellulitis – a serious infection of the tissues around the eye
- Trauma – causing bleeding or swelling in the orbit
- Vascular malformations – abnormal blood vessels in or near the orbit
- Inflammatory conditions – such as sarcoidosis or orbital pseudotumor
What are the symptoms of Proptosis?
Symptoms associated with proptosis may include:
- Noticeable bulging of one or both eyes
- Dryness, redness, or irritation of the eyes
- Difficulty closing the eyelids completely
- Double vision or vision changes
- Eye pain or a feeling of pressure behind the eye
- Swelling around the eyes or eyelids
How is Proptosis diagnosed?
Diagnosis involves a combination of:
- Physical examination – to assess the degree of eye protrusion and look for other signs
- Exophthalmometry – a tool to measure how far the eye protrudes from the orbit
- Imaging tests – such as CT scan or MRI to evaluate orbital structures and identify tumors, infections, or inflammation
- Blood tests – to check for thyroid disease or other systemic causes
What are the treatment options for Proptosis?
Treatment depends on the underlying cause:
- For thyroid eye disease: medications like corticosteroids, immunosuppressants, or newer biologic agents
- For infections: antibiotics or antifungal medications, sometimes given intravenously
- For tumors: surgical removal, radiation therapy, or chemotherapy if needed
- For trauma: management may include surgery to relieve pressure or repair orbital fractures
- Lubricating eye drops and moisture chambers may help with eye dryness and exposure
What is the recovery and prognosis for Proptosis?
- Prognosis depends on the cause and how early it’s treated
- Many cases improve with proper medical or surgical treatment
- Persistent or severe proptosis may lead to complications such as corneal damage or permanent vision loss if not managed
- Follow-up care is essential to monitor eye health and function
How can Proptosis be prevented or managed long-term?
- Prompt treatment of infections, thyroid conditions, and orbital injuries
- Regular eye exams for individuals with known risk factors (like Graves’ disease)
- Avoidance of eye trauma and protective eyewear when necessary
- Ongoing care from an ophthalmologist or specialist to prevent complications