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Exophthalmos (also called exophthalmus, exophthalmia, proptosis, or exorbitism) is a bulging of the eye anteriorly out of the orbit. Exophthalmos can be either bilateral (as is often seen in Graves' disease ) or unilateral (as is often seen in an orbital tumor).
Differential diagnosis Graves-Basedow disease Abadie's sign of exophthalmic goiter is a medical sign characterized by spasm of the levator palpebrae superioris muscle with retraction of the upper lid (so that sclera is visible above cornea ) seen in Graves-Basedow disease which, together with exophthalmos causes the bulging eyes appearance.
Stellwag's sign is a sign of infrequent or incomplete blinking associated with exophthalmos or Graves orbitopathy. It is accompanied by Dalrymple's sign, which is a retraction of the upper eyelids resulting in an apparent widening of the palpebral opening. Stellwag's sign is named after Austrian ophthalmologist Karl Stellwag von Carion.
Exophoria is a form of heterophoria in which there is a tendency of the eyes to deviate outward. [1] During examination, when the eyes are dissociated, the visual axes will appear to diverge away from one another.
Boston's sign is the spasmodic lowering of the upper eyelid on downward rotation of the eye, indicating exophthalmic goiter. [1]Similar to von Graefe's sign, it is observed in people with Graves-Basedow disease, a type of hyperthyroidism.
The diagnosis may be suspected based on symptoms and confirmed with blood tests and radioiodine uptake. [1] [4] Typically, blood tests show a raised T 3 and T 4, low TSH, increased radioiodine uptake in all areas of the thyroid, and TSI antibodies. [4] The three treatment options are radioiodine therapy, medications, and thyroid surgery. [1]
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Chronic progressive external ophthalmoplegia (CPEO) is a type of eye disorder characterized by slowly progressive inability to move the eyes and eyebrows. [1] It is often the only feature of mitochondrial disease, in which case the term CPEO may be given as the diagnosis.