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Eyes - bulging

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. But prominent eyes are not the same as bulging eyes. Bulging eyes should be checked by a doctor right away.

Bulging of one eye, especially in a child, is a very serious sign. It should be checked immediately.

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.

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 usually is a sign that the eye is bulging.

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

Common Causes

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.

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 ask about 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.

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.

Updated: 1/22/2013

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. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.


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