Bulging eyes with thyroid gland. bulging eyes

When diagnosing thyrotoxicosis, eye symptoms play an important role. A rapid pulse, an increase in the size of the gland and bulging eyes are three signs of a pathology of the gland.

Consider the causes of eye diseases, symptoms and treatment.

Causes of thyrotoxicosis

An increase in hormones - thyrotoxicosis, leads to an increase in the body's need for oxygen and increased production of heat.

This is expressed in such signs as severe sweating, tachycardia, hand trembling, anxiety.

The cardiovascular system is disturbed, changes occur with the skin, hair, eye diseases appear.

Eye diseases are mainly associated with impaired movement of the eyes and muscles of the face.

Main -

exophthalmos, protrusion of the eyeballs.

The most common is unilateral. The vegetative system plays a certain role in this.

The reason is the increased tone of the oculomotor muscles, the volume of tissues and fat increases.

All this leads to stagnation in the eyelids, increased pressure and swelling.

At the first suspicion of a disease, you should contact an endocrinologist and undergo a diagnosis.

It includes an examination of hormone levels in the blood, ultrasound findings and cardiograms.

Eye symptoms in thyrotoxicosis

With thyrotoxicosis, the palpebral fissures widen, it seems that the person is frightened or surprised.

There is increased brilliance, patients complain of "sand" in the eyes, photophobia, pain.

Symptoms of the disease are:

Delrymple - wide expansion of the slits of the eyes (surprised look).

Shtelvaga - extremely rare blinking.

Grefe - delay of the outer eyelid when moving the eyes. It occurs due to the increased tone of the muscles that are responsible for the movement of the eyelid. White scleral stripes are visible. When the pupil moves, the eyeball moves freely with it.

Möbius - the convergence of the eyeballs is disturbed, the inability to fix objects close by. The result of a greater tone of the oblique muscles than the internal rectus.

Kocher - displacement of the eyelid towards the lower or upper edge of the orbit, while exposing the sclera. The displacement may be slight, go unnoticed, or expose the cornea.

Jellineka - there is staining of the eyelids, a significant darkening of the skin.

Geofroy - wrinkling of the forehead does not occur when looking up.

Rosenbach - tremor of the eyelids with closed eyes.

Brown - there is no narrowing of the eyes when laughing.

Ekrota - the upper eyelid is swollen.

Wilder - the eyeball moves with stops, in steps.

Protrusion of the eyeballs.

Lacrimal disorder — in patients with bulging eyes. There is inflammation of the cornea due to the inability to close the eyes day or night.

All these signs of the disease, especially protrusion of the eyes and dilated palpebral fissures, make the face of a sick person look as if he was frozen with fear.

Usually these symptoms are bilateral, rarely observed unilateral.

With moderate and severe eye damage, vision is significantly reduced, double vision.

But eye symptoms are not always present, and some patients with severe disease do not.

Therefore, it is impossible to regard the disease on the basis of eye symptoms.

Doctors distinguish three severity of exophthalmos disease

• I - insignificant - (15.9±0.2) mm, there comes a slight swelling of the eyelids;
• II - medium - (17.9±0.2) mm, with a strong manifestation of edema of the eyelids and obvious signs of deformation of the muscles of the eye;
• III - strong - (22.8 + 1.1) mm, ulceration of the cornea, the movement of the apples of the eye is severely limited.

Treatment

It is carried out by methods: medicines, surgery.

The severity of the disease determines the choice of drug. Treatment of eye symptoms:

• at the initial signs of the disease, do not use large doses of imidazole;
• in the future, a long-term intake of thyroid hormones with constant monitoring of the pulse is prescribed;
• in the treatment, glucocorticosteroids and gamma therapy have a good effect while taking high doses of hormones;
• daily administration of hydrocortisone helps.

If the disease is long-term, then it is very difficult to achieve regression, due to the fact that a lot of fat and connective tissue accumulate around the eye orbits.

Conventional treatment does not help, an operation is needed to expand the orbit.

Treatment with traditional medicine is allowed as an auxiliary to the main treatment.

Herbs are brewed: cinquefoil, wild rose, hawthorn, take a tincture of walnuts.

These plants help support the body, reduce symptoms such as pressure, heartbeat.

But before taking folk remedies,

agree with your physician.

Nutrition during illness

Treatment of the disease includes complex therapy - medication and proper nutrition.

Drink plenty of water, at least 3 liters per day. The diet for illness includes the following rules:

• increase the daily calorie content of food;
• increase micronutrient intake;
• ensure the most complete protein intake, this is the basis for building muscle tissue;
• do not use stimulants - chocolate, spices, alcohol, coffee;
• do not include foods that stimulate fermentation in the diet - rice, grapes, plums, peaches;
• avoid fried, salty, sweet.

Good helps the use of strawberries, peaches.

Meat can be any, only boiled.

Fish - preferably river, it does not contain iodine.

Only with proper nutrition and medication can improve the condition and alleviate the symptoms of the disease.

You may be interested in:

The impact of diseases of the endocrine system on vision
Before it's too late: how to recognize thyrotoxicosis in time?

There is an opinion that this disease should be treated by an ophthalmologist, but this is not entirely true. In most cases, completely different specialists are involved in the treatment of bulging eyes: an endocrinologist, a neuropathologist, a traumatologist, an otolaryngologist or an oncologist. And the choice of treatment methods depends on the causes that caused this condition.

Types of bulging eyes

The surprise for most patients is that bulging is not a disease. It is only a symptom, and a symptom of many diseases. Puffy eyes manifest themselves in different ways, however, in medicine it is customary to distinguish three of its types:

Unilateral exophthalmos, when one eye protrudes from the orbit;

Bilateral exophthalmos, when both eyes protrude from the orbit;

False bulging, when the protrusion of the eyeball is a physiological norm and does not exceed a difference of 2 mm (such patients are also at risk and should be observed by a doctor).

A slight protrusion of the eyes from the orbits (from 15 to 18 mm) is considered a physiological norm. We are talking about bulging eyes, as a symptom of any alarming disease, when these indicators are exceeded by 2-8 mm.

The cause of bulging is the pathological processes occurring in the body. Therefore, the detection of exophthalmos requires a complete examination of the person to make an accurate diagnosis. After all, the cure of bulging eyes is possible only with the victory over the disease that caused it.

All pathologies that cause exophthalmos are divided into three groups:

1. Endocrine diseases. The most common cause of bulging eyes in this category is Graves' disease (goiter). It is during goiter that the thyroid gland produces an excessive amount of the hormone, which causes the immune system to increase the formation of cells. Actually, these cells load the tissues of the organ of vision, causing thickening of the oculomotor muscles, provoked by edema.

2. Diseases of different body systems. These include tumors of the brain and paranasal sinuses, inflammation of the sinuses, blood diseases, thrombosis and aneurysms of cerebral vessels, fractures of the bones of the orbit, accompanied by hemorrhage, trichinosis.

3. Eye diseases. Here, the “culprits” of bulging eyes can be: thrombosis of the orbital vein, severe, benign or malignant tumors of the orbit.

Elimination of the manifestation of exophthalmos occurs only after the intervention of a doctor of narrow specialization.

Signs and consequences of bulging eyes

Struggling with the manifestations of the diseases that caused exophthalmos, the patient saves his eyes. After all, bulging in itself is not only a problem of an aesthetic nature. Exophthalmos has a significant negative effect on the functions of the entire visual system, the violation of which can threaten complete.

Bulging is probably one of the few cases where a symptom itself has a number of symptomatic manifestations. Indeed, for people with exophthalmos, not only external manifestations of disorders are characteristic.

On the part of the organ of vision, there is a violation of the mobility of the eyes, visible objects, a feeling of pressure on the eyes,. Due to the lack of tight contact between the eyelid and the eyeball, it is not fully moistened, which can lead to its possible destruction or inflammation. There are swelling, eyelids, discs.

This condition threatens with complete blindness, which can occur due to compression of the optic nerve from increased pressure in the eye cavity. In this case, he will simply die (atrophy).

Diagnosis of bulging eyes

Timely and accurate diagnosis of exophthalmos significantly accelerates the start of treatment of the underlying disease. Bulging eyes can also be false, but, the first suspicion of such a deviation, in any case, should make you see a doctor: a general practitioner or an ophthalmologist. And already the doctor on the basis of a personal survey will recommend the right specialist.

Modern diagnostic methods will help to accurately determine the presence or absence of exophthalmos. For this apply:

Ophthalmological examination;

Computed or magnetic resonance imaging;

Laboratory research.

Treatment of bulging eyes

With bulging eyes caused by Graves' disease, correction of thyroid function is necessary. This will help courses of glucocorticosteroid drugs.

The treatment of inflammation is based on therapy or surgery.

Also, surgery is not excluded when making an oncological diagnosis. For cancer, such procedures as chemotherapy and radiation are also indicated, usually in combination.

Elimination of compression of the optic nerve is achieved during the operation, when adipose tissue is partially removed. If the cornea is damaged, complete or partial stitching of the eyelids is performed.

And the relief of the symptoms of the course of the bulging eye itself will be provided by 5 basic rules recommended by experts:

1. Maintaining constant moisture in the eyeballs. This is achieved by the use of special, commercially available ophthalmic ointments, which are applied at night.

2. Wearing sunglasses. High-quality glasses with tinted glass lenses can protect your eyes from both wind and sunlight, as well as mask bulging eyes.

3. Refusal of salt. Reducing salt intake reduces the formation of fluid in the body, which means that fluid pressure on the eye area will also decrease.

4. The use of an elevated position of the head during sleep. Even 15 cm plus the usual position of the head during sleep will help to avoid swelling of the eyelids, which increase the manifestations of bulging eyes.

5. Use of eye drops. However, it is very important to remember that instillation of drops to successfully combat the redness of the conjunctiva gives an effect only for the first 3 days. The abuse of such a procedure will only cause a greater expansion of blood vessels.

Treatment of bulging eyes is a long process, sometimes it may even take several years. The prognosis is usually favorable, but in order to achieve it, the patient needs to contact a specialist in time and scrupulously follow his recommendations.

It is important to choose an eye clinic where you will really be helped, and not "swept aside" or will "pull" money without solving the problem. The following is a rating of specialized ophthalmological institutions where you can undergo examination and treatment if you are diagnosed with bulging eyes.

A normal located eyeball almost does not protrude beyond the plane of the orbit and is slightly shifted to the outer edge. If a person notices an abnormal pathological displacement of the eyeball in himself or others, this may indicate serious health problems.

The eye can move forward (exophthalmos or protrusion), backwards (enophthalmos), and to the right or left side (lateral displacement). The nature of the displacement is determined by the main cause - the disease.

Bulging or exophthalmos is the displacement of the eyeball forward, and in some cases forward and to the side while maintaining its normal size and shape. Unilateral exophthalmos is characterized by protrusion of one eyeball, bilateral - both.

The causes of exophthalmos in one eye lie in the problems of the organs of vision, and in both eyes - in the problems of the organs of the endocrine, respiratory systems and other diseases. Pulsating exophthalmos almost always indicates diseases of the vessels of the eye or periocular tissues. There is a visual pulsation of the bulging eyeball. Pulsation exceeds the normal fluctuations of a healthy eye several times.

How does exophthalmos manifest itself?

With a closer look, you can even notice a barely beginning protrusion. Usually the sclera (the albumin of the eye) between the upper eyelid and is not visible, but with bulging eyes it is clearly visible. In this case, the patient blinks less frequently, which creates the impression of a continuous look.

The protrusion of the eye can be noticed directly by the patient during self-examination with the help of a mirror, by those around him without special preparation and, of course, by the doctor at the reception.

Because of the rare blinking of the eye, it is worse moistened, therefore, exophthalmos is often accompanied by dry eyes, a feeling of “sand” in them, and irritation. With a strong protrusion of the eyeballs, the eyelids do not completely close the eyes during sleep. This creates problems with night sleep, especially at the stage of falling asleep, and is also fraught with mechanical damage to the cornea up to perforation.

Causes of exophthalmos

Exophthalmos itself is not a disease. It is rather a symptom accompanying painful conditions. Exophthalmos occurs during pathological processes occurring in the orbit, skull, or some other diseases. In particular, the causes of exophthalmos are as follows.

What are the symptoms of exophthalmos

The symptoms of exophthalmos are as follows:

• noticeable protrusion of one or both eyeballs;
• pulsation in the pathologically located eyeball (not always);
• the inability to close the eyes completely (with advanced forms or severe course);
• dryness, pain, irritation, "sand" in the eyes;
• double vision;
• visual impairment.

The following symptoms are associated not so much with the bug itself, but with its causes:

• pain during rotation of the eyeballs;
• difficulty controlling the eyeballs;
• pain in the head;
• noise and "whistle" in the ears;
• dizziness;
• fatigue and drowsiness.

Big eyes are generally considered beautiful, but sometimes you have to watch a person’s eyeballs literally “roll out” from their sockets. What does this indicate?

health pathology

"Puffy-eyed" is scientifically called exophthalmos. And in many cases, it is a symptom of various diseases.

The most common of these is thyroid disease. Hyperthyroidism is caused by an increase in the concentration of the hormones triiodothyronine and thyroxine in the body. Excessive secretion of these hormones can lead to poisoning by them and the appearance of diffuse toxic goiter, or Basedow's disease, which has an autoimmune nature. It is also called Graves' disease, since the so-called endocrine ophthalmopathy was first described in 1835 by R. J. Graves. She suffered, by the way, Nadezhda Krupskaya, who, because of this distinctive feature - bulging eyes - was even nicknamed Lamprey.

Here is how Vladislav Leonkin describes the causes of the disease in the book “Eye Diseases: When the Mirror of the Soul Dims”:

“Due to elevated levels of thyroid hormones, what little fat there is behind the eyeball in the eye socket grows excessively. This increased adipose tissue pushes the eyeball forward."

In addition, bulging eyes can be a sign of other diseases - glaucoma, various benign and malignant tumors, cerebral vascular thrombosis, trichinosis, inflammation of the sinuses, may be the result of a traumatic brain injury.

The pathology is characterized by symptoms such as a white gap between the upper eyelids and the iris, darkening of the upper eyelid. There is also unilateral bulging, when only one eye protrudes from the orbit, and everything is in order with the second.

There is false bulging, when the eyes look protruding, but at the same time, the eyeballs are within the normal range: they protrude from the orbits by no more than 15-18 millimeters. With an anomaly, the protrusion exceeds this figure by 2-8 millimeters. Bulging eyes can often be observed in people who have been malnourished or starving for a long time. “Unfortunately, usually the cause is facial cachexia due to starvation, but this cannot be considered true exophthalmos, since in fact it is only a relative expansion of the eyes compared to the surrounding tissues,” comments V. Leonkin.

If you suspect a pathology, you should immediately consult a doctor, especially if nothing like this has ever been observed in a person before. Treatment is prescribed depending on the specific cause of the disease.

Physiological feature

Sometimes "bulging eyes" do not indicate any pathological processes in the body, they can be a physiological and even genetic feature. For example, such eyes are passed from parents to children. However, experts say that diseases associated with bulging eyes can also be inherited, so it still does not interfere with periodic examinations: such people are at risk.

Anthropological type and nationality

As for bulging eyes as a national trait, it is believed that such eyes are most often found in representatives of Jewish nationality. But no less, according to N.A. Usoltsev in the work “Anthropological differences of the human figure: sexual, facial. Conditions for creating races”, they can often be found among the peoples of the Mediterranean (for example, Spaniards, Italians, Romanians, Greeks, Egyptians), among the peoples of the Iranian group (Persian Armenians), as well as Polynesians living on the islands of Oceania.

personality traits

Specialists in physiognomy believe that people with "bulging" eyes have certain traits of character and temperament. So, Theodor Schwartz in the book “Reading Faces. Physiognomy" writes that such people have an open character, they are ambitious, decisive, reckless, inclined to take risks. “Unfortunately, people with such eyes sometimes do not look into their inner world, do not try to develop spiritually, which often leads to ridiculous recklessness,” notes Schwartz. However, in the end, the owners of bulging eyes are most often able to make the right decision. According to the researcher, they are quite sexy and sexy, and it is not surprising that people with such eyes have many admirers.

Unfortunately, there are quite a lot of different eye diseases: some of them can be determined only on special ophthalmological equipment, while others are clearly distinguished due to physical changes in the organ of vision.

Exophthalmos is a pathology that can be seen with the naked eye. With it, the eyeball protrudes forward, possibly shifting to one side.

The disease is a secondary sign of some diseases of the internal organs or an individual, congenital feature of the body.

What is exophthalmos

With a disease in the retrobulbar space of the organ of vision, a gradual increase in the volume of tissues occurs, which contributes to the protrusion of the eyeball.

Pathological development of tissues occurs as a result of inflammatory, traumatic or neurodystrophic changes of a local or general nature.

Bulging in the last stages of its development is noticeable to the naked eye. Pathology can progress both within a few years, and develop in two to three weeks.

With a significant protrusion, the mobility of the eyeball is limited and vision deteriorates. With ophthalmic diseases, exophthalmos, as a rule, develops in one eye, with general diseases in both.

The disease develops regardless of gender, age of the patient.

Classification

It is customary to classify the disease into imaginary and true.

• Imaginary exophthalmos is detected with congenital asymmetry of the orbits, expansion of the palpebral fissure, abnormal development of the cranium.
• True occurs with inflammatory, general diseases, injuries and tumors.

According to the nature of the course, the disease is divided into constant, intermittent and pulsating.

• Constant exophthalmos in most cases occurs due to neoplasms in the cavity of the orbit.
• Intermittent occurs due to pathology of the ophthalmic veins. For this form of the disease, the appearance of a protrusion is characteristic only at the time of physical stress, at which the blood supply to the vessels of the eye increases.
• Pulsating the form of the disease occurs with the development of an aneurysm of the arteries of the eye, injuries. A characteristic symptom is a pronounced and noticeable to outsiders pulsation in the eye and fixation of noise in the upper part of the apple with the eyelid closed. Along with the main symptoms, headache, tinnitus are recorded. Later, the veins on the forehead and temples noticeably expand.
• Rapidly developing hypothalamic - pituitary a form of the disease associated with an increase in the synthesis of pituitary hormones. Edema of the eyelids increases in a few days, chemosis of the conjunctiva is detected, paresis of the oculomotor nerves develops.

Pain is usually absent. Edematous exophthalmos with diffuse toxic goiter can develop both when the thyroid gland malfunctions and after its complete removal, which is associated with hormonal imbalance.

The reasons

The reasons are divided into general and local.

Local provoking factors include:

• Inflammatory processes in the orbit or adjacent areas. Local causes also include injury to the eye, pathology of the veins of the eye, neoplasms in the region of the eyeball.
• Common causes are diffuse goiter, hydrocephalus, anomalies in the development of the skull, diseases of the hematopoietic system. Inflammation of the sinuses can also be a provoking factor in exophthalmos.

Symptoms

The clinical picture depends on the degree of protrusion of the eyeball. A barely noticeable protrusion does not cause discomfort to the patient. As the disease progresses, the following symptoms may occur:

• Swelling and redness of the sclera.
• Double vision and decreased vision.
• Incomplete closure of the eyelids leads to the development of dryness of the sclera, resulting in the development of keratitis.
• The lack of movement of the eyeball or its severe limitation is a sign of a neoplasm or an acute inflammatory process in the orbit.
• On examination, pathological changes in the fundus of the eye are detected - hemorrhages, neuritis, nerve atrophy.

Prolonged compression of the optic nerve and its swelling lead to complete blindness, which cannot be corrected in the future.

Diagnostics

Only an ophthalmologist can diagnose exophthalmos by conducting a special study called exophthalmometry. It is performed using an exophthalmometer or a special ruler.

On a scale with divisions, the doctor determines the size of the cornea and compares the tops of its protrusions. After that, the dimensions of the palpebral fissure and the presence of any eye diseases are taken into account, in which it is impossible to completely close the eyelids.

Depending on these data, exophthalmos is divided into mild, moderate and severe. Any exophthalmometry corneal dimensions that exceed 20 mm, as well as 2 mm more than the difference between the highest points of the protruding cornea, are considered abnormal. A value of 28 mm is considered pronounced.

In parallel with the procedure for measuring the size of the eyes, it is necessary to carry out tests and studies of other organs that may be related to the problem: ultrasound of the thyroid gland, checking the state of the immune system, analyzing hormones, checking for the presence of abnormal processes in the eye sockets using isotope diagnostics and x-rays.

Treatment

The diagnosis is made on the basis of the clinical picture, anamnesis, and a complete examination. Exophthalmometry allows you to determine the degree of protrusion.

For successful treatment, it is necessary to establish the main cause of the pathology, therefore, not only ophthalmologists, but also endocrinologists, otolaryngologists, neurosurgeons, therapists, neuropathologists are involved in the patient.

The main direction of therapeutic measures is selected based on the identified cause of the pathology.

• In diseases of the thyroid gland, the treatment is carried out by an endocrinologist. Microdoses of iodine, Mercazolil, radioactive iodine are prescribed. The choice of drug depends on the tests for hormones. Depending on the level of hormones, pulse therapy using prednisone may also be prescribed.
• In inflammatory phenomena, antibiotics, sulfonamides, vitamin therapy, and sedatives are used.
• Pulsating exophthalmos in case of injury is treated with a pressure bandage, which allows thrombosis of the damaged vessel. Additionally, hemostatic agents are prescribed.
• Oncological neoplasms are treated with chemotherapy, radiation therapy. Surgery is used to remove the tumor.
• If compression of the optic nerve is detected, a decision is made to perform an operation aimed at reducing pressure in the membranes of the eyes. In some cases, only surgery can minimize the risk of total blindness.

Forecast

Since the causes may be different in each individual case of the disease, the prognosis will depend on:

• from a specific diagnosis;
• from the timeliness of diagnosis;
• on the severity of exophthalmos;
• on the correctness of the chosen treatment;
• from individual characteristics;
• from the combination of all of the above.

With a mild and moderate degree of exophthalmos, the prognosis can be favorable if the exact cause or causes of the disease are identified in time and properly eliminated by contacting specialists.

For any form of exophthalmos, the doctor may recommend surgery (plastic surgery), further actions will depend on the root cause of the eye disease.

Prevention

First of all, prevention should include a healthy lifestyle: proper nutrition, moderate physical activity, giving up bad habits, avoiding stressful situations; Thus, the immunity of the whole organism will rise.

If a doctor is under observation due to any disease, then all his recommendations must be followed so that there are no complications in the disease that may manifest itself in a disease of the organs of vision.

You should especially protect your head and eyes from injury during hazardous activities, monitor eye hygiene, treat infectious and inflammatory diseases of the upper respiratory tract in time, if you suspect a violation of the thyroid gland, undergo an examination, take a general blood test.

Conclusion

Any disease can develop as a result of an inattentive attitude to one's health, this is the reason for the lack of time, and simply the unwillingness to change something. Exophthalmos also belongs to such diseases, therefore, so that there is no risk to vision or even the danger of losing it completely, it is necessary to follow preventive measures and attend medical consultations.

If you are concerned about your eye health for a reason, and the doctor has not confirmed your doubts, visit another doctor to hear a few opinions and make a decision. It is always easier to prevent a disease and there will be much more chances if treatment is carried out at an early stage of detection.

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