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Diabetes is a lifelong chronic disease that is caused by high levels of sugar in the blood. When it comes to your feet, there are several risk factors that can increase your chances of developing foot problems and diabetic infections in the legs and feet. People who have long-standing or poorly controlled diabetes are also at risk for having damage to the nerves in their feet, which is known in the medical community as peripheral neuropathy. Normal nerves allow people to sense if their shoes are too tight or if their shoes are rubbing on the feet too much.
White color is visibly seen on the area between the iris and the upper eyelid if a person has bulging eyes.
Graves’s disease, histiocytosis, hyperthyroidism, orbital cellulitis, leukemia or other forms of cancer, perioribital cellulitis and neuroblastoma are some of the other factors that cause proptosis. Hypothyroidism is the condition in which adequate quantities of thyroid hormone is released in the body since TSH receptors trigger its production. Cancers like leukemia, melanoma and brain tumors can directly affect the eyes leading to protrusion of eyes.
Your doctor will measure the extent of bulging eyes using a ruler or by special instrument called exopthalmometer.
Treatment for protopsis depends entirely on the underlying issue, if it is caused by any health factor.
Arterio-venous malformations, or AVMs, are a collection of abnormal vessels which may occur within virtually any part of the brain tissue. To understand AVMs, it is helpful to first discuss normal blood flow function within the body. As blood flows from the heart into the large arteries, it is pumped at relatively high pressure and speed, both of which decrease as the blood flow reaches smaller and smaller arteries.
AVMs occur when the relatively large arteries within the brain directly connect to veins without the capillary mesh that normally exists between them.
AVMs are most often congenital (present at birth) and usually no specific cause for the AVM can be identified. Arterio-venous malformations (AVMs) are typically diagnosed by a CT scan or MRI upon presentation of symptoms that may include seizures, headache or stroke-like episodes. There are three major treatment methods that may be useful either alone or in combination to treat an AVM. Open surgical treatment involves removing a portion of the skull so that surgical instruments can be inserted to remove the AVM. Embolization is an endovascular technique (performed from within the blood vessels) to block the vessels of the AVM. Carotid-cavernous fistulae are abnormal connections between the carotid artery (or its branches) and a large vein (cavernous sinus) behind the eye. Direct carotid-cavernous sinus fistulae generally are associated with trauma or surgical manipulation and are therefore commonly seen in young men.
Indirect (low-flow) fistulae can form as a result of trauma, clotting of the sinus with subsequent reopening, or rupture of an aneurysm (a weak spot in a vessel which causes the vessel wall to balloon out and eventually rupture) of the carotid artery where it passes through the sinus. The symptoms include pulsating bulging of the eye, redness and swelling of the whites of the eyes, increased pressure in the eye (glaucoma), loss of vision in the eye (occurs in 20-30% of patients with indirect carotid-cavernous sinus fistulae), double vision, and pain.
Dural arteriovenous fistulae are abnormal connections between arteries in the head and the large veins that are found in the covering of the brain (dural sinuses) which are responsible for draining the brain. These fistulae can result from trauma, infections (such as sinus infections or mastoiditis), or from clotting of the vein. Treatment of an AVM is directed toward preventing brain injury that could result from bleeding or re-bleeding. Vascular malformations are an abnormal vessel or vessels that form a direct connection between arteries and veins without the normal capillary mesh between them to facilitate blood flow.
Vascular malformations are an abnormal vessel or vessels forming a direct connection between arteries and veins without the normal capillary mesh between them to facilitate bloodflow.
Symptoms are caused when increased blood flow through the malformations enlarge the vessels, putting pressure on surrounding structures and causing deformity of the face (often tongue, lip, eyelid). When vascular malformations do not disappear, or, cause symptoms, grow with age, or appear during adult life, a variety of treatment options may be considered. Another treatment option utilized by doctors involves placing a needle directly through the skin into the malformation and injecting material to block off the malformation. Glaucoma is the name given to a group of eye diseases in which the optic nerve at the back of the eye is damaged. About 3% of Australians have glaucoma but, because there are generally no warning signs, only about half of them have been diagnosed. In most people this damage is due to an increased pressure inside the eye – a result of blockage of the circulation of the aqueous, or its drainage. Digital Fundus Photos - these enable us to examine the optic nerve head for early changes in appearance which might suggest glaucoma. Pachmetry- this measures the thickness of the cornea (the clear window at the front of the eye) and allows us to adjust the eye pressure reading appropriately. OCT (Ocular Coherence Tomography) scans the retina down to the cellular level and aids in detection of early damage to the optic nerve fibre layer.


There is no one test which is diagnostic for glaucoma and in most cases the doctor will rely on all of the above information when deciding when to treat.
Although there is no cure for glaucoma it can usually be controlled and further loss of sight either prevented or at least slowed down. Laser (laser trabeculoplasty) – this is performed when eye drops do not stop deterioration in the field of vision.
Surgery (trabeculectomy) – this is performed usually after eye drops and laser have failed to control the eye pressure. It can also decrease your body’s ability to fight off infections, which is especially harmful in your feet. Normal sweat secretion and oil production that lubricates the skin of the foot is impaired, which can lead to an abnormal pressure on the skin, bones, and joints of the foot during walking and other activities.
First of all, poorly fitting shoes are one of the biggest culprits of diabetic foot complications. If you have nerve damage, you may not be able to feel your feet normally and you may also be unable to sense the position of your feet and toes while walking and balancing, which can cause even more harm to your feet. With diabetes, you may not be able to properly sense minor injuries, such as cuts, scrapes and blisters-all signs of abnormal wear, tear, and foot strain. You can avoid serious problems such as losing a toe, foot, or leg by following proper prevention techniques offered by your podiatrist. Depending on the underlying health factor a person may get fever, excess of sweat, irritation and headache.
But there are some cases where people acquire this condition due to underlying disease like glaucoma or thyroid problem.
Certain serious type of eye infection can cause swelling and protrusion of eyes leading to protopsis.
In case if the measurement is out of reach for measuring he may do MRI scanning or ultrasound scan for verifying the extent of damage caused. In case bulging eyes are caused by high blood sugar, medications are given to control diabetes. They are thought to arise during fetal development and occur in less than 1% of the population.
In a healthy individual, blood normally flows from the heart through arteries to supply all organs including the brain. Eventually the blood reaches the smallest vessels called capillaries, vessels smaller than the diameter of a human hair.
Because of the abnormal “short circuit,” the blood is delivered at relatively higher pressure with more rapid flow directly into the veins. In the vast majority of cases, AVMs are not inherited and other members of the family are not at increased risk for having an AVM.
Once an AVM is confirmed, an angiogram or arteriogram is performed to identify the vessels involved in the malformation. The specific treatment for an individual is based on the patient’s history, symptoms, and anatomy of the AVM including its size, feeding arteries, draining veins, and location within the brain. In this procedure, a small catheter is threaded from the groin directly into the AVM vessels within the brain. Embolization is often able to decrease the size of the AVM making the surgery much safer than would otherwise be the case. With this particular condition, there is a direct connection between the arteries and the sinus without any normal capillary mesh between the two.
No treatment currently exists which can repair damage already done to the brain by the AVM. In the spine, vascular malformations can involve: the spinal cord, the tissues around the spinal cord within the spinal canal, the bones of the spine, the tissues around the spine, or a combination of these. Malformations in particular areas can result in weakness and in severe cases, paralysis, of some or all limbs. Symptoms can be caused by decreased blood supply to the spine and nerves, by pressure from the abnormal vessels, or by rupture of the vessels resulting in hemorrhage. These malformations can occur in the tissues of the face and neck (extracranial) or surrounding the spine (paraspinal). Excess pressure on the nerves can cause difficulties with functions such as eyesight or swallowing. This process progresses very slowly and destroys vision gradually, starting with the peripheral (side) vision. One of the most sinister characteristics of glaucoma is that a person with glaucoma is unaware of any visual problems until a majority of nerve fibres have been irreversibly damaged.
Laser is used to try to unblock or increase the filtration of the aqueous through the trabecular meshwork, hence lowering the intraocular pressure. Surgery is conducted on the trabecular meshwork to increase the outflow of the aqueous, lowering the intraocular pressure.
When diabetes is not properly controlled, damage can occur to the organs and impairment of the immune system is also likely to occur.
This can even lead to the breakdown of the skin of the foot, which often causes sores to develop.


If you have red spots, sore spots, blisters, corns, calluses, or consistent pain associated with wearing shoes, new proper fitted shoes must be obtained immediately. It can be unilateral which is bulging out of one eye and bilateral in which both the eyes are bulging. Some of the other signs of proptosis are discomfort in opening and closing the eyes, difficulty in sleeping or blinking, dryness of eyes, discomfort or pain in making eye movements, scarring seen inside the eyes and excess of white part on the eyes. Similarly for problems like thyroid hormone and other diseases suitable treatments are given to manage the symptoms effectively. Four major arteries supply the brain including two carotid arteries in the front of the neck and two vertebral arteries in the back of the neck.
As the blood flows slowly through these tiny conduits, it gives up oxygen and nutrients to the brain tissue and receives carbon dioxide and other waste products in return.
Because the veins are not designed for this condition, they expand, pushing against the neighboring areas of normal brain. Angiography is the only test currently available that provides sufficiently detailed information useful in planning and implementing therapy of most AVMs. Treatments include: endovascular embolization (closure of the AVM from within the blood vessels), open surgical removal of the AVM, or a combination of techniques. The combination of embolization followed by surgical resection is frequently safer than surgical resection alone in treating an AVM. Under X-ray guidance, material is injected through the catheter to permanently block and close off the vessels of the AVM. However, the blood flow from certain AVM’s may be totally blocked by embolization techniques, and no further therapy may be required.
Sometimes, the same method is utilized so that the carotid artery itself may be blocked off to close the fistula. The most dangerous complication of a fistula is rupture of the vein, resulting in hemorrhage in or around the brain. If the fistula increases the pressure in the veins responsible for draining the brain, neurological symptoms and headaches may be present. Often, these fistulae are treated through endovascular methods by placing a catheter into the blood vessels and injecting materials to block off the vessels, a procedure called embolization.
For example, seizures might continue after embolization or even complete removal of the AVM. Including all types of malformations, the incidence in the general population is approximately 3-7%. These lesions are often congenital (present at birth) and can change greatly as a child grows. In other cases, vascular malformations are treated through endovascular methods by placing a catheter into the blood vessels supplying the malformation and injecting various materials to block off the blood supply to the abnormal vessels. Treatment cannot recover what has been lost, but it can arrest, or at least, slow down the damage process. If you have diabetes, it is important to prevent foot problems before they occur, recognize problems early, and seek the right treatment when a problem does happen. Additionally, if you have common foot abnormalities such as flat feet, bunions, or hammertoes, prescription shoes or orthotics from your podiatrist may be necessary to further protect your feet from other damage. The intensity of bulging of eyes varies from mild to severe and only an eye doctor can assess the intensity of seriousness.
You can detect this by looking at photographs taken some years ago and comparing it with recently taken photo. This in turn develops into swelling of fat cells due to accumulation of fluid forcing the eyes to bulge out from the socket. Additionally, an enlarging AVM can cause seizures and pressure which ultimately may lead to a neurological deficit. The blood then enters tiny veins at very low pressure, eventually entering larger veins in its return to the heart and lungs. The result may be damage to the normal brain tissue which can cause weakness, numbness, loss of vision, or seizures. If this is necessary, tests are performed first to make sure that there is enough blood flow to the brain from the other arteries. Patients with neurological deficits resulting from AVM hemorrhage would likely still experience the same deficits after treatment of the AVM, although improvement may occur.
It is believed to be caused by the increased pressure inside the eyes due to underlying disorder. Thus, pressure and speed of blood flow in the veins (the vessels that return blood to the heart) are normally very low compared to that of the arteries (the vessels responsible to deliver or pump blood from the heart to the rest of the body). Often the supplying arteries, the AVM itself, or the enlarged veins rupture, resulting in the most common presentation of an AVM, an intracranial hemorrhage which is a type of stroke. Because of this design, the walls of the veins are relatively thin and delicate compared to those of the arteries which must be thicker and more inflexible to handle higher pressure and speed.



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