Eyes - bulging

Protruding eyes; Exophthalmos; Proptosis; Bulging eyes

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.

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 may include:

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

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.

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.

Treatments depend on the cause. Artificial tears may be given to lubricate the eye.