Bulging Eyes (Proptosis, Exophthalmos) Causes

What Causes Bulging Eyes?

Often a sign of a medical problem, bulging eyes can be caused by various health issues.
Often a sign of a medical problem, bulging eyes can be caused by various health issues.

Several different health problems can make one or both of your eyes appear to stick out from their sockets. This symptom can also make it hard for you to blink. You might describe it as bulging eyes. Doctors call it proptosis or exophthalmos.

It can happen when you have a thyroid problem, an injury, infection, or other health condition. If one or both of your eyes have begun to bulge, even if they don’t hurt, see your doctor. It’s usually a sign of a problem that needs treatment.

Early action is the best way to protect your vision. Here are some possible reasons your eyes may bulge and ways to treat whatever condition is causing it.

Graves’ Disease, Thyroid Eye Disease

If both of your eyes slowly bulge over time, Graves’ eye disease is the most likely cause. The condition also goes by other names: Graves’ orbitopathy, Graves’ ophthalmopathy, and thyroid eye disease. You can get this eye disease if you have Graves’ disease. That’s a disorder of the immune system that causes your body to make extra thyroid hormone.

Eye problems may start about 6 months after you develop Graves’ disease, but it could also happen sooner depending on the severity of the disease.

With Graves’ eye disease, the immune system -- your body’s way of killing germs -- mistakenly attacks muscle and tissue around your eyes. The area then swells and pushes your eyes forward.

You should talk to your doctor as soon as you notice a change in your eyes. It doesn’t happen often, but swollen tissue can press on the nerve that connects your eye to your brain. If that happens, you can lose your vision.

Besides bulging eyes, you may have other symptoms such as:

Signs you have a serious eye problem include:

  • Trouble moving your eyes or eyelids
  • Inability to close your eyelids
  • Vision problems

Your doctor may give you:

  • Eye drops to help with dryness
  • A steroid shot for swelling

The doctor might also recommend that you:

  • Prop your head up to sleep more comfortably
  • Wear a sleep mask or, if they won’t close, tape your eyes shut to sleep

Your eyes may get better on their own. But your regular doctor might want you to see an ophthalmologist. This eye specialist can take a closer look and see if you need surgery.

Bulge in Eye From Infection

Germs can get into your eye or the sensitive area around it. The tissue around your eye socket can then swell and push your eye forward. One eye infection than can cause this is orbital cellulitis. With this infection, usually only one eye bulges out. You may also feel pain in your eye. And it may hurt when you try to look around.

Other symptoms of orbital cellulitis include:

  • Redness
  • Swollen eyelids
  • Pain when moving your eye
  • Inability to move your eye
  • Vision problems
  • Fever
  • Sinus problems

It’s important to see a doctor if you have signs of an infection. Without treatment, orbital cellulitis could lead to vision loss or make you very sick. Antibiotics can help you get better. But in some cases, you may need surgery.

Eye Tumor Causes of Bulging Eyes

A tumor behind your eye can make it bulge. This can happen whether the tumor is cancerous (malignant) or not (benign). Tumors don’t necessarily cause pain unless they get big.

If a tumor is the cause of your bulging eye, you may also have a headache or double vision. It could feel like something is in your eye. You might also have an eye that:

  • Itches
  • Burns
  • Turns red in the white part

See your doctor right away if you have symptoms that include:

  • Spots or wavy lines in your field of vision
  • Flashes of light
  • A dark spot that grows in the colored part of your eye
  • A change in your pupil’s size or shape
  • Vision loss
  • A change in how your eye moves
  • A change in where your eye sits in the socket

Your doctor can run some tests to find out if you have cancer. If you do, you may get radiation, chemotherapy, or laser treatment to kill your cancer cells. A surgeon might need to take out your tumor with surgery.

Bulge in Eye From Injury

Your eye socket may swell if your eye is cut or hit. Blood can build up around the injury. This can make your eye stick out.

If you injured your eye, you might also have:

  • Eye pain
  • Vision problems
  • Blood in your eye
  • A bruise near your eye

A mild injury like a small scratch may heal by itself. But you should get an eye exam just to be safe. You should see a doctor right away if:

  • There’s an object in your eye
  • Your eyeball is cut
  • Your pupils aren’t the same size
  • You have a child with an injured eye

Glaucoma Causes of Bulging Eyes

Glaucoma is an eye disorder that can damage the nerves that go from your eyes to your brain. One of the symptoms is an increase in eye pressure. This elevated pressure causes eyes to bulge.

Glaucoma usually develops when you’re older. If you get it before you’re 40, it’s called early-onset glaucoma. Though uncommon, kids can be born with it. If they are, it’s called primary congenital glaucoma.

If you have early-onset glaucoma, you may also:

  • Have watery eyes
  • Be extra sensitive to light (photophobia)

Glaucoma that develops later can include these symptoms:

Glaucoma can sometimes be a medical emergency. See your doctor right away if you have:

Your doctor may give you medicine or laser treatment to drain fluid from your eye fast.

You can’t stop glaucoma from happening. But your eye doctor can check for it in your yearly eye exam. If you have it, you may get eye drops to lower eye pressure. You might also need laser treatment or surgery.

References
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Merck Manuals: “Eyes, Bulging,” “Orbital Cellulitis.”

American Thyroid Association: “Graves’ Eye Disease.”

NHS (UK): “Exophthalmos.”

National Institute of Diabetes and Digestive and Kidney Diseases (NIH): “Graves’ Disease.”

American Cancer Society: “Signs and Symptoms of Eye Cancer,” “If You Have Eye Cancer.”

Canadian Cancer Society: “Non-cancerous tumors of the eye.”

American Academy of Ophthalmology: “Recognizing and Treating Eye Injuries,” “First Aid for Eye Scratches.”

Seattle Children’s Hospital: “Eye Injury.”

National Eye Institute (NIH): “Glaucoma,” “Types of Glaucoma.”

U.S. National Library of Medicine (NIH): “Early-onset glaucoma.”
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