Eyes - bulging

Definition

Bulging eyes is the abnormal protrusion (bulging out) of one or both eyeballs.

Alternative Names

Protruding eyes; Exophthalmos; Proptosis; Bulging eyes

Considerations

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

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

Hyperthyroidism (particularly Graves disease) is 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 there is abnormal eye bulging.

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

Common Causes

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

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 take your medical history and do a physical examination.

Medical history questions may include the following:

• 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.

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

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References

Davies TF, Larsen PR. Thyrotoxicosis. In: Kronenberg HM, Melmed, S, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008: chap 11.

Olitsky SE, Hug D, SMith LP. Orbital abnormalities. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th Ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 632.

Dutton JJ. Orbital diseases. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier; 2008:chap 12.12.