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Graves' disease
Graves' disease


Hyperthyroidism
Hyperthyroidism


Periorbital cellulitis
Periorbital cellulitis


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:

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.



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.

Robinett DA, Kahn, JH. The physical examination of the eye. Emerg Med Clin N Am. 2008;26:1-16.




Review Date: 2/1/2009
Reviewed By: Linda Vorvick, MD, Family Physician, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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Wentworth-Douglass Hospital
789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
Toll free: 1 (877) 201-7100