Exophthalmos natural history, complications and prognosis

Proptosis can compromise visual function and the integrity of the eye. A proptotic eye can develop exposure punctuate keratopathy. This will result in corneal compromise, epithelial death, ulceration, and possible corneal perforation. Proptosis secondary to a space-occupying process can result in a compressive optic neuropathy as well. Such manifestations as depression of visual and color acuities, pupillary dysfunction, and constriction of visual field can occur.

If left untreated, exophthalmos can causes the eye lids to fail to close during sleep leading to corneal damage. The process that is causing the displacement of the eye may also compress the optic nerve or ophthalmic artery leading to blindness.