What is a bulging eye?

A bulging eye is a problem where one or both of your eyes are pushed forward. In severe cases, your eyelids can no longer cover the entire front of your eye. Depending on the cause and how much your eye is pushed forward, this condition may be called exophthalmos or proptosis.

What is the cause?

Bulging eyes can be caused by:

• Graves’ disease, a thyroid disease that is a common cause of eyes that bulge
• Inflammation or tumors of the eye socket
• Abnormal blood vessels behind your eye
• An injury to the eye socket
• A bacterial infection in your eye socket. This is an emergency. If not treated quickly, the infection can spread from your eye socket to the brain. It can cause blindness and can be life threatening.

What are the symptoms?

Symptoms may include:

• Eyes that bulge forward more than usual from the sockets, and eyelids that do not completely close over the eyes. Your eyes may look different from each other.
• Dry, red eyes that feel scratchy. The dryness may happen because your eyelids are not covering enough of your eye or they do not close all the way. Your eyes may dry out while you sleep, which may lead to eye damage.
• Watery eyes
• Decreased vision, or double vision if the muscles that control eye movements are affected
• Swelling and irritation of the eye

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and do exams and tests such as:

• An exam using a microscope with a light attached, called a slit lamp, to look closely at the front and back of your eye
• An exam using drops to enlarge, or dilate, your pupils and a light to look into the back of your eyes
• A test of the way your pupils react to light
• CT scan, which uses X-rays and a computer to show detailed pictures of your eye socket
• An ultrasound, which uses sound waves to show pictures of your eye
• Blood tests to check thyroid hormone levels

How is it treated?

Treatment depends on the cause.

Artificial tears or ointment at night can help dry eyes. Sometimes steroid drugs or low doses of radiation are used to reduce the swelling and irritation around the eye. If you have double vision, prism glasses may help.

If you have hyperthyroidism, treating your high thyroid hormone levels is an important part of your overall health. Your provider may prescribe medicine to control your thyroid hormone levels. You may need regular blood tests to check your hormone levels and make sure they are in good control. If you smoke, your provider will advise you to quit, because smoking worsens eye disease caused by thyroid problems.

If you have an infection, you will be treated with antibiotics.

You may need surgery if your eyes push forward due to an injury or a tumor, or if your eyelids can’t close completely. If your eyelids can’t close, it can lead to cuts or infections on the cornea (the clear outer layer on the front of your eye), or even blindness.

How can I take care of myself?

Follow the full course of treatment your healthcare provider prescribes. Ask your healthcare provider:

• How and when you will hear your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent bulging eyes?

There is no way to prevent some of the problems that cause your eyes to bulge. However, serious problems with your eyes and blindness can be prevented by early diagnosis and treatment. Have regular checkups. Contact your healthcare provider if you develop any symptoms that concern you.