Intermittent proptosis

Introduction to intermittent eyeballs Intermittent exophthalmos (intermittent exophthalmos) is mostly unilateral, the incidence of left eye is higher than the right eye, more common in male patients. Vascular diseases are less common in eyeballs. Most of the exophthalmos are caused by congenital or acquired internal iliac veins, especially supraorbital varices. No trauma and other medical history. There is no specific treatment, in severe cases, surgical resection of varicose veins or venous ligation may be considered, but sequelae such as extraocular muscle paralysis may occur after surgery. basic knowledge Sickness ratio: 0.0001% Susceptible population: more common in male patients Mode of infection: non-infectious Complications: exposed keratitis

Causes of intermittent ocular protrusion

Cause:

Most of the exophthalmos caused by congenital or acquired internal iliac veins, especially the supraorbital varices, no trauma and other medical history. This disease is thought to be caused by congenital factors. There are two types of orbital varices, one is primary, without any prodromal expansion of vascular malformation; the second is secondary, increased venous pressure, driving vasodilatation, such as carotid-cavernous sinus fistula Axillary varices belong to this category.

Intermittent eyeball prevention

1, in order to prevent seizures, do not oppress the jugular vein, the collar should not be too tight, do not bow to the heavy physical labor, the supine position should be taken.

2, as far as possible to avoid bowing, excessive force and various causes of increased internal jugular venous pressure and eyeballs; sleep pillow high, sneezing, coughing when the patient oppresses the eye; when you must bow your labor, use the squat Operation, etc.

Intermittent eyeball complications Complications exposed keratitis

Exposure keratitis is prone to occur when the eyeball is severely protruded. Due to the protrusion of the eyeball, the exposure of the cornea surface, the evaporation of the tears is too fast, the corneal epithelium is dry, blurred, necrotic, shedding, ulcer or corneal epithelial keratinosis, accompanied by matrix infiltration and turbidity, if the degree of cleft palate is incomplete and due to closed eyes When the eyeball is up-regulating (Bell phenomenon), only one-third or less of the one is exposed, the corneal damage is also limited to this part, because the corneal perception is reduced, the invasion of foreign objects can not be reflected and blocked, so the damage is easy. Even secondary to bacterial and fungal infections.

Symptoms of intermittent ocular protrusion Common symptoms Edema, vertigo, tinnitus, IOP, elevated eyeball, invagination, conjunctival hyperemia, diplopia, extraocular shift, nausea, ptosis

1. Temporary eyeballs are an important feature of this disease. The degree of prominence can be increased or decreased with the change of the head position. The duration is different. Frequent or occasional episodes, the patient is bowing, exhaling vigorously, pressing the jugular vein or neck. When the side is twisted, it can arouse the temporary eyeball protrusion. It also shows: the ptosis of the upper eyelid, swelling of the sputum, conjunctival congestion and edema, dilated pupils, retinal varicose veins, blurred vision of the nipple, eye movement disorders and elevated intraocular pressure .

2, the eye has a sense of tension at the time of attack, occasional diplopia and temporary vision loss, and dizziness, headache, nausea, vomiting and tinnitus and other systemic symptoms or ipsilateral paralysis, facial veins dilated.

3, after the attack, the eyeball returned to the original position, all the above symptoms subsided, but often showed eyeball retraction, due to vasodilation, long-term compression of the fat tissue in the sputum caused by atrophy.

Intermittent eyeball examination

According to the medical history, using the transparent scale or Hertel eyeball protrusion meter to measure the position of the eyeball and the degree of eyeball protrusion, the average degree of eyeball protrusion in China is 13.6mm. If it is higher or lower than this number, it can be considered as protrusion or subsidence. , but must be measured simultaneously and need to be measured several times between equivalent time intervals for comparison.

Diagnosis and diagnosis of intermittent eyeball protrusion

diagnosis

Diagnosis can be performed based on clinical manifestations and examinations.

Differential diagnosis

Mainly need to distinguish from the obvious symptoms of eyeball caused by some diseases, such as hyperthyroidism, eyeball protrusion and other eyeballs caused by space-occupying lesions, etc., this disease is a temporary eyeball protrusion, can recover to the original position after the attack; and hyperthyroidism, tumor If the eyeball is prominent, the eyeball will not be reset if the primary disease is not cured.

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