What Does Bulging Eyes (Exophthalmos) Indicate?
![Exophthalmus or bulging eyes is most commonly a symptom of a thyroid disorder called Grave's disease, but may have other causes as well.](https://images.emedicinehealth.com/images/article/main_image/bulging-eyes.jpg?output-quality=75)
The medical term for bulging eyes is exophthalmos. It is not a condition in itself, but a symptom of other conditions.
What Are Symptoms of Bulging Eyes (Exophthalmos)?
Bulging eyes (exophthalmos) are a symptom of other conditions. Depending on the cause, symptoms that may accompany bulging eyes may include:
- Eye pain
- Changes in visual clarity or sharpness
- Double vision
- Decreased fields of vision
- Temporary vision loss or blackout periods
- Foreign body sensation
- Dry, gritty eyes
- Eye redness
- Puffy eyes
- Eye inflammation and swelling
- Sensitivity to light (photosensitivity)
- Tearing
What Causes Bulging Eyes (Exophthalmos)?
Causes of bulging eyes (exophthalmos) can include:
- Inflammatory
- Thyroid orbitopathy (Graves’ disease), the most common cause
- Orbital inflammatory syndrome (orbital pseudotumor, benign orbital inflammation)
- Erdheim-Chester disease
- Vascular
- Orbital arteriovenous malformation (AVM) varices (carotid-cavernous sinus fistula, arteriovenous malformation)
- Orbital varix (venous malformation)
- Aneurysms
- Wegener granulomatosis
- Churg-Strauss syndrome
- Infectious
- Orbital cellulitis
- Subperiosteal abscesses
- Mucormycosis
- Concurrent sinus disease
- Endocrine
- Cancerous (both benign and malignant)
- Lacrimal
- Meningioma
- Lymphoma
- Leukemia
- Rhabdomyosarcoma
- Retinoblastoma
- Capillary hemangioma
- Glioma
- Ossifying fibroma
- Dermoid cyst
- Hand-Schüller-Christian disease
- Metastatic disease (breast in women, lung and prostate in men, as well as gastrointestinal and kidney)
- Traumatic
- Orbital emphysema
- Carotid-cavernous fistula
- Traumatic or iatrogenic orbital hemorrhage
- Orbital fractures
- Facial fractures
- Other
- Craniosynostosis
- Pfeiffer syndrome
- Apert syndrome
- Crouzon syndrome
- Carpenter syndrome
How Is Bulging Eyes (Exophthalmos) Diagnosed?
The cause of bulging eyes (exophthalmos) is diagnosed with a history and physical exam, and the following tests:
- Measurement of the degree of eye protrusion with an exophthalmometer
- Blood tests
- Complete blood count (CBC)
- Thyroid function studies
- Nasal cultures
- Imaging studies
- Computerized tomography (CT)
- X-rays
- Magnetic resonance imaging (MRI)
- Ultrasound
- Bone marrow biopsy
What Is the Treatment for Bulging Eyes (Exophthalmos)?
Treatment for bulging eyes (exophthalmos) depends on the cause and is aimed at reversing the problem and minimizing damage to the eye.
- Teprotumumab (Tepezza) is used to treat thyroid eye disease in adults
- Ophthalmic lubricants are used to prevent complications from dry eyes
- Artificial tears (Celluvisc, Murine, Refresh, Tears Naturale)
- Polyethylene glycol 400/propylene glycol ophthalmic (Systane Balance, Systane Ultra, Tears Naturale Free, Hypo Tears, Murine Tears)
- Carboxymethylcellulose ophthalmic (Refresh Optive Gel Drops, TheraTears Nighttime Dry Eye Therapy)
- Hypromellose/carboxymethylcellulose ophthalmic (Genteal Lubricant Eye Drops, Moderate-to-Severe)
- Sunglasses to ease light sensitivity
- Corticosteroids
- Stop smoking
- Radiotherapy for the active stage of thyroid eye disease
- Chemotherapy for cancerous causes
- Antibiotics for infectious causes
- Surgery in severe cases
- Orbital decompression surgery, in which a small amount of bone is removed from 1 or both eye sockets
- Eyelid surgery to improve the position, closure, or appearance of the eyelids
- Eye muscle surgery to bring the eyes into alignment and reduce double vision
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