EXOPHTHALMOS

Ask the following questions:

1. Is it bilateral or unilateral? Bilateral exophthalmos would suggest hyperthyroidism. Unilateral exophthalmos suggests orbital tumor, abscess, or aneurysm.
2. If it is bilateral, are there signs of hyperthyroidism? If there are other indications of hyperthyroidism, Graves' disease would be the diagnosis.
3. If it is unilateral, does the eyeball pulsate? A pulsating eyeball would suggest an arteriovenous fistula, and there should be a loud blowing murmur over the orbit.
4. Is there fever? Fever would suggest acute cellulitis, acute sinusitis, periostitis, or a cavernous sinus thrombosis.
5. Is there chemosis or ecchymosis? These signs are suggestive of a cavernous sinus thrombosis.

DIAGNOSTIC WORKUP

In cases of bilateral exophthalmos, particularly if there is no fever or chemosis or ecchymosis, a thyroid profile is the most valuable test. Orbital MRI may also be done. However, Graves' disease may be present with normal thyroid function tests. Testing for thyrotropin receptor antibody and peroxidase antibodies should be done in these cases. Other endocrine studies may be necessary once hyperthyroidism has been excluded. In cases of unilateral exophthalmos, ultrasonography and plain films of the orbits and sinuses may be helpful, but a CT scan of the brain and sinuses is the most valuable diagnostic aid. Carotid angiography will need to be done to diagnose an arteriovenous fistula.

Book Source Details

• Book Title: Algorithmic Diagnosis of Symptoms and Signs
• Author(s): R. Douglas Collins
• Year of Publication: 2003
• Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

Other Book Chapters Related to Bulging eyes

Read excerpts from these other book chapters related to Bulging eyes:

Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2008 Williams & Wilkins.

More About Causes of Bulging eyes

• Back to symptom: Bulging eyes: Introduction (review 179 causes)
• Next Book Extract About Bulging eyes: EYE PAIN (Algorithmic Diagnosis of Symptoms and Signs)
• All Book Extracts: All Online Book Extracts for Bulging eyes

More About This Book: Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9

 » Next page: EYE PAIN (Algorithmic Diagnosis of Symptoms and Signs)

Rate This Website

What do you think about the features of this website? Take our user survey and have your say:

Website User Survey

Medical Tools & Articles:

Next articles:

• EYE PAIN (Algorithmic Diagnosis of Symptoms and Signs)
• Red Eye (In a Page: Signs and Symptoms)
• Proptosis/Exophthalmos (In a Page: Signs and Symptoms)
• Proptosis/Exophthalmos (In A Page: Pediatric Signs and Symptoms)
• Scleral Injection (Red Eye) (In A Page: Pediatric Signs and Symptoms)

Tools & Services:

• Bookmark this page
• Take a survey relating to Bulging eyes
• Symptom Search
• Symptom Checker
• Medical Dictionary
• Give your feedback

Medical Articles:

• Disease & Treatments Search
• Misdiagnosis Center
• Full list of interesting articles

Forums & Message Boards

• Ask or answer a question at the Boards:
• I cannot get a diagnosis. Please help.
• Tell us your medical story.
• Share your misdiagnosis story.
• What is the best treatment for my condition?
• See all the Boards.

Enter your search terms Submit search form
Search The Web Search wrongdiagnosis.com

Common Health Mistakes

Symptom
Checker

Search Specialists by State and City