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<h2>What is Exophthalmos? 
</h2>
Exophthalmos is a condition where the eyeball protrudes more than normal from the eye socket, causing pain or a throbbing sensation. People with exophthalmos have their corneas exposed to sunlight and wind more than usual, leading to eye irritation, itching, tearing, and redness. Some people feel like there is something in their eye when they move their eyes (Gritty Sensation). Some patients with exophthalmos come to the doctor with symptoms such as blurred vision, abnormal image perception, color vision changes, or seeing double images when moving their eyes.
<h2>Diagnosis of Exophthalmos 
</h2>
To diagnose whether a patient has exophthalmos, the eye&#8217;s protrusion is measured. The eyeball protrudes at least 2 millimeters more than normal. In Asians, a device called the Hertel Exophthalmometer is used for measurement. The standard value is 18 millimeters; if the measurement exceeds 18 millimeters, it is considered exophthalmos.
<h2>Causes of Exophthalmos 
</h2>
The causes of exophthalmos differ between children and adults, as follows:
<h2>Common causes in children</h2>
<ul>
<li>Tumor group (Dermoid)</li>
<li>Vascular tumor (Capillary Hemangioma)</li>
<li>Infection in the eye area (Orbital Cellulitis)</li>
</ul>
<h2>Common causes in adults</h2>
<ul>
<li>Thyroid disease (Thyroid)</li>
<li>Lymphoma (Lymphoma)</li>
<li>Vascular tumor (Cavernous Hemangioma)</li>
<li>Unknown cause of inflammation (Orbital Cellulitis)</li>
<li>Cancer metastasis around the eye area</li>
</ul>
<h2>Treatment Approaches for Exophthalmos 
</h2>
The main treatment approach is initially non-invasive, without surgery, which includes:
<ul>
<li>Symptomatic treatment such as treating dry eyes, irritation, and tearing with artificial tears, wearing sunglasses to protect from sunlight and wind, and using eye pressure-lowering medication if intraocular pressure is high.</li>
<li>Treatment based on the cause such as antibiotics for infections, chemotherapy or cancer drugs for cancer, thyroid medication, radioactive iodine, or radiation therapy for thyroid-related causes.</li>
</ul>
<h2>When is Surgery Necessary for Exophthalmos? 
</h2>
Surgical treatment for exophthalmos is usually performed when the patient has the following symptoms:
<ul>
<li>Presence of a tumor in the eye area, which requires tumor removal to create space around the eye bones</li>
<li>Double vision</li>
<li>Compression of the optic nerve causing reduced vision, color vision loss, corneal damage due to protrusion, or inability to close the eyelids completely</li>
<li>High eye pressure that does not respond to medication</li>
<li>Surgery needed for cosmetic reasons, important for work and daily life appearance</li>
</ul>
<h2>How to Prevent Exophthalmos 
</h2>
Patients with thyroid disease should have annual health check-ups and blood tests to prevent exophthalmos caused by hyperthyroidism. It is found that within one year, up to 60% of patients with thyroid abnormalities develop eye symptoms. People aged 35 and older, even without health problems, should also have regular annual health check-ups.
&nbsp;
Dr. Fontip Na Pompet
Ophthalmologist specializing in orbital diseases
and oculoplastic surgery
Eye Center, Phyathai 2 Hospital

Proptosis is a condition where the eyeball protrudes more than normal from the eye socket, causing pain, a throbbing sensation in some people, and a feeling as if there is something in the eye when moving the eye. In severe cases, it can cause blurred vision, abnormal perception of images and colors, or double vision.

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Pterygium, early detection and treatment may not require surgery.

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