Bulging eyes

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Alternative names
Protruding eyes; Exophthalmos; Proptosis; Eyes - bulging

Definition
Bulging eyes involve the abnormal protrusion of one or both eyeballs.

Considerations

Prominent eyes may be a family characteristic. However, prominent eyes are not the same as bulging eyes. Bulging eyes should receive prompt attention.

Bulging of a single eye, especially in a child, is a very significant sign and should be evaluated immediately.

Hyperthyroidism (particularly Graves’ disease) is probably the most common cause of bulging eyes. With this condition, the eyes don’t blink very often and seem to have a staring quality.

Generally, there should be no visible white between the top of the iris (the colored part of the eye) and the upper eyelid. Seeing white in this area is usually a good indication that the eye bulging is abnormal.

Because eye changes develop slowly, family members may not notice until the condition is relatively advanced. Photographs often draw attention to the bulging when it may have gone unnoticed previously.

Common Causes

• Hyperthyroidism
  
• Graves’ disease
  
• Histiocytosis
  
• Rhabdomyosarcoma
  
• Neuroblastoma
  
• Leukemia
  
• Orbital cellulitis (or periorbital cellulitis)
  
• Hyperthyroidism caused by medications for other conditions
  
• Hemangioma
  
• Glaucoma

Home Care
The underlying cause of this symptom needs to be treated by a health care provider. Because bulging eyes can cause a person to be self-conscious, emotional support is important.

Call your health care provider if

• You have bulging eyes and the cause has not yet been diagnosed.
  
• Bulging eyes are accompanied by other symptoms.

What to expect at your health care provider’s office

The health care provider will obtain your medical history and will perform a physical examination.

Medical history questions may include the following:

• Are both eyes affected?
  
• When did you first notice bulging eyes?
  
• Is it getting worse?
  
• What other symptoms do you have?

A slit-lamp examination may be ordered. Blood testing for thyroid disease may be performed.

Artificial tears may be given to lubricate the eye(s). Other treatments will depend on the cause.

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