| 词条 | Exophthalmos |
| 释义 |
| name = Exophthalmos | image = 406907P-PA-OCULAR.jpg | caption = Patient with left eye proptosis | | pronounce = | field = | synonyms = | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }} 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). Complete or partial dislocation from the orbit is also possible from trauma or swelling of surrounding tissue resulting from trauma. In the case of Graves' disease, the displacement of the eye is due to abnormal connective tissue deposition in the orbit and extraocular muscles which can be visualized by CT or MRI.[1] If left untreated, exophthalmos can cause the eyelids to fail to close during sleep leading to corneal dryness and damage. Another possible complication is a form of redness or irritation called "Superior limbic keratoconjunctivitis", where the area above the cornea becomes inflamed as a result of increased friction when blinking. The process that is causing the displacement of the eye may also compress the optic nerve or ophthalmic artery, leading to blindness. CausesInflammatory/Infection:
Neoplastic:
Cystic:
Vascular:
Others:
Anatomy{{see also|Anatomical terms of location}}Proptosis is the anterior displacement of the eye from the orbit. Since the orbit is closed off posteriorly, medially and laterally, any enlargement of structures located within will cause the anterior displacement of the eye.[3] Swelling or enlargement of the lacrimal gland causes inferior medial and anterior dislocation of the eye. This is because the lacrimal glands are located superiorly and laterally in the orbit.[3] DiagnosisMeasurementMeasurement of the degree of exophthalmos is performed using an exophthalmometer. Most sources define exophthalmos/proptosis as a protrusion of the globe greater than 18 mm.[1] The term exophthalmos is often used when describing proptosis associated with Graves' disease.[4] AnimalsExophthalmos is commonly found in dogs. It is seen in brachycephalic (short-nosed) dog breeds because of the shallow orbit. It can lead to keratitis secondary to exposure of the cornea. Exophthalmos is commonly seen in the pug, Boston terrier, Pekingese, and shih tzu. It is a common result of head trauma and pressure exerted on the front of the neck too hard in dogs. In cats, eye proptosis is uncommon and is often accompanied by facial fractures.[5] About 40% of proptosed eyes retain vision after being replaced in the orbit, but in cats very few retain vision.[6] Replacement of the eye requires general anesthesia. The eyelids are pulled outward, and the eye is gently pushed back into place. The eyelids are sewn together in a procedure known as tarsorrhaphy for about five days to keep the eye in place.[7] Replaced eyes have a higher rate of keratoconjunctivitis sicca and keratitis and often require lifelong treatment. If the damage is severe, the eye is removed in a relatively simple surgery known as enucleation of the eye. The prognosis for a replaced eye is determined by the extent of damage to the cornea and sclera, the presence or absence of a pupillary light reflex, and the presence of ruptured rectus muscles. The rectus muscles normally help hold the eye in place and direct eye movement. Rupture of more than two rectus muscles usually requires the eye to be removed, because significant blood vessel and nerve damage also usually occurs.[7] Compared to brachycephalic breeds, dochilocephalic (long-nosed) breeds usually have more trauma to the eye and its surrounding structures, so the prognosis is worse.[8] See also
References1. ^1 {{cite book|author1=Owen Epstein |author2=David Perkin |author3=John Cookson |author4=David P de Bono |title=Clinical examination |edition=3rd|publisher=Mosby|location=St. Louis|date=April 2003|isbn=0-7234-3229-5}} 2. ^1 {{cite book|last=Goldman|first=Lee|title=Goldman's Cecil Medicine|publisher=Elsevier Saunders|location=Philadelphia|isbn=1437727883|pages=2430|edition=24th}} 3. ^1 {{cite book|last=Mitchell|first=Richard N|title=Pocket companion to Robbins and Cotran pathologic basis of disease|publisher=Elsevier Saunders|location=Philadelphia, PA|isbn=978-1416054542|chapter=Eye|edition=8th}} 4. ^{{cite web|last=Mercandetti|first=Michael|title=Exophthalmos|url=http://emedicine.medscape.com/article/1218575-overview|work=WebMD, LLC|publisher=Medscape|accessdate=6 December 2012}} 5. ^{{cite web | title = Prolapse of the Eye | work = The Merck Veterinary Manual | year = 2006 | url = http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/30119.htm | accessdate = 2007-03-23 }} 6. ^{{cite web | last = Gelatt | first = Kirk | title = Treatment of Orbital Diseases in Small Animals | work = Proceedings of the 27th World Congress of the World Small Animal Veterinary Association | year = 2002 | url = http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2002&PID=2641 | accessdate = 2007-03-23 }} 7. ^1 {{cite book|author=Gelatt, Kirk N. (ed.)|title=Veterinary Ophthalmology|edition=3rd|publisher=Lippincott, Williams & Wilkins|year=1999|isbn=0-683-30076-8}} 8. ^{{cite web | last = Bjerk | first = Ellen | title = Ocular Injuries in General Practice | work = Proceedings of the 29th World Congress of the World Small Animal Veterinary Association | year = 2004 | url = http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2004&PID=8722&O=Generic | accessdate = 2007-03-23 }} External links{{Medical resources| ICD10 = {{ICD10|H|05|2|h|00}} | ICD9 = {{ICD9|376.2}}-{{ICD9|376.3}} | ICDO = | OMIM = | MedlinePlus = 003033 | eMedicineSubj = oph | eMedicineTopic = 616 | DiseasesDB = 18612 | MeshID = D005094 }}{{Eye pathology}} 2 : Dog diseases|Disorders of eyelid, lacrimal system and orbit |
| 随便看 |
|
开放百科全书收录14589846条英语、德语、日语等多语种百科知识，基本涵盖了大多数领域的百科知识，是一部内容自由、开放的电子版国际百科全书。