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Eyes - bulging
Protruding eyes; Exophthalmos; Proptosis; Bulging eyes
Bulging eyes is the abnormal protrusion (bulging out) of one or both eyeballs.
Considerations
Prominent eyes may be a family trait. But prominent eyes are not the same as bulging eyes. Bulging eyes should be checked by a health care provider right away.
Bulging of one eye, especially in a child, is a very serious sign. It should be checked right away.
Hyperthyroidism (particularly Graves disease ) is the most common cause of bulging eyes. With this condition, the eyes do not blink often and seem to have a staring quality.
Hyperthyroidism
Hyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is often called overactive thyroid.
Graves disease
Graves disease is an autoimmune disorder that leads to an overactive thyroid gland (hyperthyroidism). An autoimmune disorder is a condition that occ...
Normally, 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 most often is a sign that the eye is bulging.
Because eye changes develop slowly, family members may not notice it until the condition is fairly advanced. Photos often draw attention to the bulging when it may have gone unnoticed before.
Causes
Causes may include:
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Glaucoma
Glaucoma
Glaucoma is a group of eye conditions that can damage the optic nerve. This nerve sends the images you see to your brain. Most often, optic nerve da...
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Hemangioma
Hemangioma
A hemangioma is an abnormal buildup of blood vessels in the skin or internal organs.
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Histiocytosis
Histiocytosis
Histiocytosis is a general name for a group of disorders or "syndromes" that involve an abnormal increase in the number of specialized white blood ce...
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- Hyperthyroidism caused by medications for other conditions
- Leukemia
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Neuroblastoma
Neuroblastoma
Neuroblastoma is a very rare type of cancerous tumor that develops from nerve tissue. It usually occurs in infants and children.
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Orbital cellulitis
or
periorbital cellulitis
Orbital cellulitis
Orbital cellulitis is an infection of the fat and muscles around the eye. It affects the eyelids, eyebrows, and cheeks. It may begin suddenly or be...
ImageRead Article Now Book Mark ArticlePeriorbital cellulitis
Periorbital cellulitis is an infection of the eyelid or skin around the eye.
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Rhabdomyosarcoma
Rhabdomyosarcoma
Rhabdomyosarcoma is a cancerous (malignant) tumor of the muscles that are attached to the bones. This cancer mostly affects children.
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Home Care
The cause needs to be treated by a health care provider. Because bulging eyes can cause a person to be self-conscious, emotional support is important.
When to Contact a Medical Professional
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 Office Visit
The provider will ask about your medical history and do a physical exam.
Some questions you may be asked include:
- Are both eyes bulging?
- When did you first notice bulging eyes?
- Is it getting worse?
- What other symptoms do you have?
A slit-lamp examination may be done. Blood testing for thyroid disease may be done.
Slit-lamp examination
The slit-lamp examination looks at structures that are at the front of the eye.
Treatments depend on the cause. Artificial tears may be given to lubricate the eye.
References
Clemmons DR. Approach to the patient with endocrine disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 228.
Yanoff M, Cameron D. Diseases of the visual system. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 431.
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Graves' disease - illustration
Graves disease is an autoimmune disorder that involves overactivity of the thyroid gland (hyperthyroidism). Hallmarks of the condition are bulging eyes (exophthalmos), heat intolerance, increased energy, difficulty sleeping, diarrhea, and anxiety.
Graves' disease
illustration
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Hyperthyroidism - illustration
A goiter is a swelling in the neck due to an enlarged thyroid gland. The size may range from a single small nodule to a large neck lump. The swollen thyroid can put pressure on the windpipe and esophagus which can cause a cough, wheezing, breathing difficulties or swallowing difficulties. A goiter only needs to be treated if it is causing symptoms.
Hyperthyroidism
illustration
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Periorbital cellulitis - illustration
Periorbital cellulitis is an acute infection of the tissues surrounding the eye, which may progress to orbital cellulitis with protrusion of the eyeball. Complications include meningitis.
Periorbital cellulitis
illustration
-
Graves' disease - illustration
Graves disease is an autoimmune disorder that involves overactivity of the thyroid gland (hyperthyroidism). Hallmarks of the condition are bulging eyes (exophthalmos), heat intolerance, increased energy, difficulty sleeping, diarrhea, and anxiety.
Graves' disease
illustration
-
Hyperthyroidism - illustration
A goiter is a swelling in the neck due to an enlarged thyroid gland. The size may range from a single small nodule to a large neck lump. The swollen thyroid can put pressure on the windpipe and esophagus which can cause a cough, wheezing, breathing difficulties or swallowing difficulties. A goiter only needs to be treated if it is causing symptoms.
Hyperthyroidism
illustration
-
Periorbital cellulitis - illustration
Periorbital cellulitis is an acute infection of the tissues surrounding the eye, which may progress to orbital cellulitis with protrusion of the eyeball. Complications include meningitis.
Periorbital cellulitis
illustration
Review Date: 1/31/2015
Reviewed By: Linda J. Vorvick, MD, medical director and director of didactic curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
