What Causes Exophthalmos (Bulging Eyes)?
Exophthalmos, the term ophthalmologists use to describe bulging eyes, may be caused by several health conditions or diseases. Determining the cause of your condition is the first step in treating exophthalmos.
5 Causes of Exophthalmos
Exophthalmos occurs when one eye or both eyes protrude more than normal. The change can happen gradually or suddenly and may be caused by:
- Graves' Eye Disease. If you have an overactive thyroid gland (hyperthyroidism), you may be at increased risk for developing Graves' Eye Disease, the most common cause of exophthalmos, according to Ophthalmology Breaking News. As thyroid hormone production increases, tissues and muscles surrounding the eyes become inflamed and swell, causing the eyes to bulge.
- Cellulitis. Inflammation and swelling can also cause bulging if you have cellulitis. Cellulitis, an infection of the skin or tissues, can occur anywhere in the body. Orbital or pre-orbital cellulitis affects the skin and tissues around the eyes. Cellulitis can be caused by a sinus infection or an eye injury. The infection may also develop after cataract surgery or other eye surgeries, although this is a rare complication. Cellulitis is a serious infection that can lead to vision loss if it's not treated promptly.
- Eye Injury. An eye injury that causes bleeding could be the reason for a bulging eye. As blood builds up in the eye socket, it may push your eye forward.
- Tumors. Tumors, both benign (non-cancerous) and malignant (cancerous), can cause exophthalmos.
- Glaucoma. Glaucoma is often caused by increased intraocular pressure. The high pressure can damage the optic nerve, the connection between the brain and eye, and cause vision loss. Although exophthalmos doesn't commonly occur in glaucoma, it can happen in severe cases.
As women are more likely to develop thyroid disease and Graves' disease, your risk for exophthalmos is higher if you're female. According to WebMD, women usually develop Graves' disease before age 40. Smokers are also at increased risk of exophthalmos, as smoking may affect thyroid function or worsen thyroid disease.
It's important to see your ophthalmologist as soon as you notice exophthalmos symptoms. If bulging is accompanied by eye pain, a fever or an eye injury, call your ophthalmologist immediately or go to the emergency room.
Exophthalmos Symptoms
In addition to bulging eyes, you may notice these signs and symptoms if you have exophthalmos:
- Pain In or Around Your Eyes
- Dry Eyes
- Redness in or Around Your Eyes
- Swollen Eyelids or Eyelids That Don't Close Completely
- Difficulty Seeing (You may experience blurry or double vision.)
- Trouble Moving the Eye Normally
- Light Sensitivity
If you have an infection, you may also develop a fever.
Diagnosing and Treating Exophthalmos
Your visit to the ophthalmologist includes an up-close examination of your eyes with a lighted microscope called a slit-lamp and tests of eye movements and visual fields.
An exophthalmometer may be used to measure the protrusion of your eyes. Your eye doctor might recommend several other tests, such as a magnetic resonance imaging (MRI) or computed tomography (CT) scan. A blood test to measure your thyroid function may also be ordered.
Treatment for exophthalmos depends on the cause. If you have Graves' disease, treating your thyroid disease is often the first step. Eye doctors often prescribe corticosteroids, medication that eases inflammation and swelling responsible for bulging. Your ophthalmologist may also recommend lubricating eye drops to moisten the eyes and relieve itching, redness, burning and other dry eye symptoms.
Antibiotics may be needed if you have an infection. You might receive these antibiotics through an intravenous (IV) line at the hospital. Your ophthalmologist may recommend surgery to relieve pressure, drain an abscess or infected sinuses, or make the bony space that holds the eyes bigger if you have a severe case of exophthalmos.
Are you concerned that you may have exophthalmos? Contact our office immediately to schedule an appointment with the ophthalmologist.
Sources:
Ophthalmology Breaking News: Bulging Eyes: What Causes Exophthalmos and How to Treat It, 5/24/2023
https://ophthalmologybreakingnews.com/bulging-eyes--what-causes-exophthalmos-and-how-to-treat-it
WebMD: What Causes Bulging Eyes (Exophthalmos)?, 2/15/2024
https://www.webmd.com/eye-health/bulging-eyes-exophthalmos-causes
MedLinePlus: Eyes – Bulging, 2/2/2023
https://medlineplus.gov/ency/article/003033.htm
All About Vision: Exophthalmos (Bulging Eyes, 1/20/2021
https://www.allaboutvision.com/conditions/exophthalmos/
National Eye Institute: Graves’ Eye Disease, 11/15/2023
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/graves-eye-disease