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July 1944


Author Affiliations

From the Johns Hopkins Hospital and University.

Arch Ophthalmol. 1944;32(1):1-10. doi:10.1001/archopht.1944.00890070017001

Intermittent exophthalmos is a rare, but striking and unmistakable, syndrome. It is characterized by pronounced and rapid—almost instantaneous—protrusion of one eye when venous stasis is induced by bending the head forward ; by lowering the head ; by turning the head forcibly ; by hyperextension of the neck ; by coughing ; by forced expiration, with or without compression of the nostrils, and by pressure on the jugular veins. The ocular protrusion disappears immediately when the head is erect and when artificially induced venous congestion is relieved.

Usually, but not invariably, there is enophthalmos when venous congestion does not obtain. There may or apparently may not (to judge from cases reported in the literature) be pulsation of the eyeball. Vision may or may not be affected. The condition is progressive and may be productive of unbearable pain and troublesome diplopia. The appearance is unsightly, but life is not at stake.

The case here reported—the only