What can cause bulging eyes to develop?
Ask the expert
Q. My 50-year-old son has developed bulging eyes over the last few months. It makes him look different, and I would like to know what may cause this.
A. Your son's appearance could be the result of a condition called exophthalmos, bulging out of one or both eyes. The other term doctors use to describe the same problem is proptosis. Some experts have defined the terms differently, but most of us use them interchangeably.
Sometimes eyes can appear to be bulging when a person has lost a lot of weight. The eyes remain the same, but the fat and muscle around the face is diminished. This makes the eyes look like they bulge in comparison.
When the proptosis is caused by thyroid eye disease, doctors refer to it as exophthalmos. Most people with thyroid eye disease have Graves' disease, an autoimmune disorder. The condition happens when the body produces thyroid stimulating proteins that cause the thyroid gland to become overactive.
The disease also can cause proteins to accumulate in certain tissues, most commonly in the muscles that control eye movements. These muscles are called the extraocular muscles. They enlarge and push the eyes forward. Usually both eyes are affected.
Most people with Graves' eye disease have symptoms of an overactive thyroid, including anxiety, tremor, difficulty sleeping, weight loss despite an excellent appetite, and intolerance of heat.
Another rare cause of exophthalmos is glaucoma that occurs in early childhood. Because the eye is fully developed in adults, the much more common adult onset glaucoma doesn't make eyes bulge.
Most other causes of proptosis involve only one eye. Causes include:
- infection
- injury
- bleeding behind the eye
- a blood clot behind the eye
- a tumor.
Your son should make an appointment with his doctor. He will probably need to see an eye specialist if proptosis is confirmed on exam.
Image: © ablokhin/Getty Images
About the Author
Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
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