Bulging eyes or protruding eyeballs – known as proptosis or exophthalmos – is often a sign of a serious medical condition. In a healthy individual, the white part of the eye is not visible over the iris. If the white part is showing between the iris and the eyelid, this is known as bulging eyeball.
In some cases, bulging eyeballs can be hereditary while in others it could be caused by a medical condition. Treatment for protruding eyeballs depends on the cause.
Causes of Bulging Eyes
The most common cause of bulging eyes is hyperthyroidism (overactive thyroid). In this case, the thyroid gland produces too many hormones over a short period of time and is usually accompanied by other health complications too. Another cause for bulging eyes is Grave’s disease, an autoimmune disease and a common cause of hyperthyroidism. In Grave’s disease, the tissue around the eyes becomes inflamed, creating a bulging effect. Women over the age of 20 are at the highest risk for Grave’s disease, although it can affect anyone.
Other causes of exophthalmos include:
- Bleeding behind the eye due to injury
- Abnormal buildup of blood vessels beneath the skin
- Neuroblastoma (nerve cell cancer)
- Orbital cellulitis
- Periorbital cellulitis
- Rhabdomyosarcoma – cancerous tumor in the muscles attached to the bones
- Vascular disorders
Symptoms of Bulging Eyes
The most obvious symptom of bulging eyes is a change in the appearance of the eyes. Other signs and symptoms include:
- Difficulty closing the eyes fully
- Drying of the cornea
- Scarring of the eye, which can lead to permanent vision loss
- Difficulty with eye movement
- Increase in the visibility of the sclera – the white part of the eye
Symptoms of bulging eyes can relate to the underlying condition that has caused it. For example, if bulging eyes are due to hyperthyroidism, you may also experience unexplained weight loss, changes in appetite, increased sweating, and frequent bowel movements such as diarrhea.
When to See a Doctor for Bulging Eyes
There are a few questions you will want to ask your doctor about your bulging eyes. What caused it? What treatments are available? Are there any over-the-counter products that can reduce the appearance of bulging eyes? What prevention tips can I follow to ensure the condition doesn’t worsen?
You should see a doctor for bulging eyes as soon as you spot the changes to your eyes, especially if you have noticed other changes in your overall health. The earlier you see your doctor, the sooner treatment can start and the smaller the risk of complications will be.
Complications of Proptosis
If left untreated, bulging eyes may cause the eyelids to be unable to close during sleep, which causes the cornea to become dry and damaged. This also causes a higher risk of infection and ulcers, which can lead to vision problems.
Patients are also at a higher risk for conjunctivitis and superior limbic keratoconjunctivitis, where the area above the cornea becomes inflamed as a result of abnormal tearing and blinking.
In rare cases, some patients may experience compression of the optic nerve or ophthalmic artery, which can affect eyesight overtime to the point where blindness may occur.
Diagnosing exophthalmos can often be done easily by a doctor simply looking at the eye and noticing that it is protruding. In order to determine the cause of exophthalmos, a doctor will require additional testing such as a blood test to determine thyroid function, measuring the protrusion using an exophthalmometer, and imaging scans like CT or MRI to detect any tumors or other abnormalities around the eye or scans of the brain to evaluate the structure.
Your doctor may also request specific tests for the eyes like a vision test, dilated eye exam, and slit-lamp exam to determine if there is any damage to the eyes or vision.
Exercises to Reduce Bulging Eyes
Exercising your eyes can be important, as it helps strengthen the muscles of the eyes. One type of exercise involves laying down and closing your eyes. Now, with your eyelids closed, move your eyes to the very right and hold for a few seconds, then to the far left and hold for a few seconds. Follow-up this exercise with moving your eyes all the way to the top and then all the way to the bottom. The last exercise involves moving your eyes in a clockwise position, and then a counterclockwise position.
Repeat each exercise five times a few times a day. You can take a short break in between exercises by opening your eyelids.
At first, you may experience some pressure, but the more you perform these, exercises the fewer symptoms you will experience.
Tips for Bulging Eyes Patients
Aside from eye exercises and the treatment your doctor lays out for you, there are other tips to keep in mind to protect your eyes and visions. These tips include smoking cessation, keeping your head slightly elevated while you sleep, wearing sunglasses, trying to protect the eyes from irritants, using eye drops to relieve soreness and treat dry eyes, and wearing glasses with special prisms to correct double vision.
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