The most common cause of bulging eyes (proptosis/exophthalmos) is Grave’s disease, an autoimmune disease. It causes enlargement of the muscles which are responsible for eye movements. Additionally, the vascular congestion and swelling around the eyes cause pressure effects and pushes the eyeballs forward.
Grave’s eye disease is 3 to 10 times more common in females than in males. The mean age of appearance of Grave’s thyroid disease is about 41-42 years.
This disease is usually self-limited and stabilizes in 8-36 months on its own.
Other causes of exophthalmos (bulging eyes) include:
- Bleeding behind the eye due to injury
- Abnormal buildup of blood vessels beneath the skin
- Neuroblastoma (nerve cell cancer)
- Orbital cellulitis
- Periorbital cellulitis
- Vascular disorders
Rhabdomyosarcoma is the most common cancer of orbit in children. Bulging eyes (proptosis) is usually the first symptom when it is suspected.
Bulging eyes can cause blindness in two important ways: One, the inflamed and swollen muscles and surrounding soft tissue can cause compression of optic nerve. Two, the protruded eyes result into exposure and damage to cornea leading to dryness, opacity and even infection of cornea. The treatment of bulging eyes in Grave’s eye disease aims to address these issues.
Radiation, immuno-suppresion and surgical methods are used to reduce the factors causing compression on the optic nerve and the eyeball in general.
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