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The exophthalmos (pucheglazy) is a state at which at the person one or at once both eyeglobes are displaced forward, at the same time the deviation of eyeglobes can be observed aside.
Symptoms of an exophthalmos are shown only by the shift of eyeglobes, but their sizes remain normal. Pucheglaziye is observed at the person at a number of diseases — at the Bazedovy illness, fibrinferments and aneurisms of vessels of a brain, tumors of an orbit and a brain, inflammations in an orbit and bosoms of a nose, etc.
The so-called edematous endocrine exophthalmos is observed at the people having the Bazedovy illness. At development of this disease in the person the enlargement of the thyroid gland, weakness of muscles, slackness and symptoms of a hyperthyroidism is noted. In an organism of the patient with the Bazedovy illness there are products of abnormal protein under the influence of which the thyroid gland functions excessively intensively.
In medicine the imaginary and true exophthalmos is defined. Manifestations of an imaginary exophthalmos are observed at people who have inborn asymmetry of eyes of eye-sockets, some anomalies of a skull, an expanded palpebral fissure, the increased eyeglobe sizes. In turn, the true exophthalmos is subdivided on inflammatory, noninflammatory and tumoral.
Eyeglobe the person with an exophthalmos can have Vypuchivaniye both almost imperceptible, and strongly expressed. At the expressed vypuchivaniye the hyperthermia and hypostases a century, chemoses can be noted. Depending on expressiveness of an exophthalmos the eyeglobe can or remain mobile, or to some extent lose mobility. If the eyeglobe does not move or its mobility is strongly limited, the doctor can suspect existence of a strong inflammation in an eye-socket or tumor snowballing. Vision disorders can be noted depending on that, pathological process is how strongly expressed.
At some forms of an exophthalmos at the patient intraocular pressure increases. It is possible at an edematous form which arises spontaneously or after removal at the person of a thyroid gland. In this case the patient can complain of periodic orbital pains, visual acuity lowering.
The pulsing exophthalmos is shown by protrusion of an eyeglobe and its pulsation. Development of the false pulsing exophthalmos happens at patients to brain tumors, aneurism of vessels of an eye-socket and an internal carotid artery. The true pulsing exophthalmos — result of injuries and a rupture of a wall of the general carotid artery. As a result, penetration of an arterial blood into an upper orbital vein is noted, there is an expansion of its walls and protrusion of eye-sockets. At the pulsing exophthalmos of the patient can suffer from headaches, periodically shown sonitus.
Emergence of the alternating exophthalmos is connected with a number of diseases of eyes. It is shown when the person inclines the head.
Damage of oculomotor muscles turns out to be consequence of shift of eyeglobes that as a result conducts to squint. At the shift of eyeglobes and limitation of mobility at the person the expressed diplopia is often observed. Also at the expressed shift of eyeglobes dense contact between an upper and lower eyelid is impossible. As a result the cornea of an eye is not humidified in enough, and at the patient the keratopathy, that is the dystrophic processes in a cornea leading to serious inflammatory processes can develop. The most serious complication of an exophthalmos is the prelum of an optic nerve happening because of the increased intraocular pressure. As a result, the blood flow and conductivity of signals on nerve fibrils is broken. The nerve can die completely, and at the person the total blindness develops.
The reasons of an exophthalmos can be connected with development of some diseases. The exophthalmos often develops owing to an endocrine ophthalmopathy. At this disease the bilateral exophthalmos is, as a rule, observed. The reasons of a unilateral exophthalmos are often connected with different diseases of eyes. Less often the unilateral exophthalmos is observed at a hyperthyroidism and at other general diseases.
Manifestations the pucheglaziya can be connected with inflammatory diseases of the lacrimal glands, fatty tissues of an eye-socket, with vasculites of orbital vessels. Also this symptom can be observed at eye-socket tumors, varicosity of veins of an eye-socket, after injuries which consequence hemorrhage for an eyeglobe is.
Also the exophthalmos can be one of symptoms at inborn glaucoma, unilateral short-sightedness, a hypothalamic syndrome, hydrocephaly. Vypuchivaniye of an eyeglobe can be a precursory symptom of development of tumors of an orbit which can have both high-quality, and malignant character.
Illness pucheglazy — so sometimes call Bazedova an illness at which at the person the strong vypuchivaniye of eyes noticeable even on a photo is noted. Pucheglaziye at the person sick with the Bazedovy illness, develops not in connection with increase in an eyeglobe. Bazedova an illness is shown at the person owing to development of autoimmune processes which are shown at people with a hereditary favor, at influence of certain external and internal factors. Pucheglaziye at people can be shown at hormonal failures, diseases of endocrine system, viral diseases, owing to influence of radiation, etc. Most often Bazedova an illness develops at women, pucheglazy at children is observed seldom.
Before to start directly treatment of an exophthalmos, it is necessary to establish the correct diagnosis and to define why at the person this state was shown. The diagnosis is established in the course of ophthalmologic survey, and also by means of detailed poll of the patient who has to tell the specialist about features of development of a disease in detail. Special procedure which is called an ekzoftalmometriya practices. On the course of such inspection by means of special mirrors the specialist estimates features of an arrangement of eyeglobes. If necessary the computer or magnetic and resonant tomography also practices. Information obtained during these researches allows to define the happened changes more precisely.
To confirm the diagnosis, sometimes also the specialist appoints to the patient carrying out laboratory researches for the purpose of establishment of level of hormones of a thyroid gland.
Treatment of an exophthalmos depends on that, changes, and also from the reason of development of this symptom are how expressed. How to treat an exophthalmos, the doctor defines after establishment of the exact diagnosis. If the endocrine ophthalmopathy is diagnosed for the patient, then treatment a pucheglaziya is carried out by correction of functions of a thyroid gland. The course of treatment glucocorticosteroid drugs is in that case appointed. It is necessary to understand that in this case you should not practice treatment by folk remedies not to aggravate a state of health.
If at the person inflammatory process is noted, carrying out antiinflammatory treatment, and also the administration of drugs reducing toxic influence of inflammatory processes on an organism is necessary. The doctor can sometimes make the decision on treatment by means of surgical intervention. So, at the expressed exophthalmos elimination of squeezing of an optic nerve is carried out. At damage of a cornea perhaps carrying out partial or full sewing together a century.
In the presence of oncological pathology to the patient operation and the subsequent radiation therapy or chemotherapy is performed.
At establishment of the diagnosis "a false exophthalmos" and existence of a small physical vypuchivaniye of eyes treatment is not carried out, however for the patient regular supervision is conducted.
At the Bazedovy illness treatment is appointed by the doctor-endocrinologist. First of all the patient has to accept a rate of drugs which promote suppression of activity of a thyroid gland. Initially the doctor appoints high doses, later they gradually decrease. The constant control of level of hormones of a thyroid gland is important. Complex treatment includes reception of glucocorticoids, immunoproofreaders.
In the absence of efficiency after treatment surgical intervention can be carried out by medicines. During such operation the part of a thyroid gland is removed. Also treatment of the Bazedovy illness can be carried out by method of use of a radioiodine. However such method practices for treatment of people of advanced age.