There are many causes of exophthalmos (bulging eyes), also known as proptosis, but the most common cause is Grave’s disease – an autoimmune disease which affects the thyroid gland, causing the overproduction of thyroid hormones, leading to abnormalities in various organs – including the eyes.

Exophthalmos is the main symptom of Grave’s disease. It occurs as a result of excess hormones accumulating in the muscles and fatty tissues behind the eyes. It causes swelling in the eye sockets, which leads to protruding eyes. The condition occurs gradually until it becomes clearly noticeable. In some cases, patients may also experience double vision and abnormal eye movement.

Side Effects

Common side effects of exophthalmos include:

  • Reduced vision
  • Double vision
  • Sore eyes
  • Redness and Irritation
  • Dry eyes
  • Overactive tear ducts
  • Pressure behind the eyes.
  • Crossed eyes
  • Glaucoma
  • Inability to close the eyes completely
  • Retracting eyelids (the upper eye lid rests higher than normal and the lower eye lid rests lower than normal)

Patients must undergo exophthalmos treatment alongside thyrotoxicosis treatment simultaneously. The patient must see an endocrinologist to keep their hormones at a controlled hormone level in order for successful exophthalmos treatment.

The first stage of exophthalmos treatment involves symptomatic treatment – with symptoms changing every 2-3 months. In cases which double vision, crossed eyes, and eyelid abnormalities occur, steroid medication may be considered.

In most instances, exophthalmos begins to settle approximately 1 ½–2 years after it sets in. Some patients may recover completely or have reduced bulging, while others continue to have substantial bulging. Surgical correction of the eye socket can be carried out by an expert ophthalmologist specializing in orbital and cosmetic eye surgery for cases of substantial bulging due to ineffective treatment.

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