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General Medical Questions
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Question : My 45-year-old husband has developed bulging eyes over the last few months. It makes him look different. What might cause this?
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The Trusted Source
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Howard LeWine, M.D.

Howard LeWine, M.D., is chief editor of Internet Publishing, Harvard Health Publications. He is a clinical instructor of medicine at Harvard Medical School and Brigham and Women's Hospital. Dr. LeWine has been a primary care internist and teacher of internal medicine since 1978.

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August 08, 2013
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This could be from a condition called exophthalmos, an abnormal bulging out of one or both eyes. Doctors also use the word proptosis to describe the same problem. 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 there’s less fat and muscle around the face. This makes the eyes look like they bulge in comparison.

The most common cause of true exophthalmos is Graves’ disease, an autoimmune disorder. For unknown reasons, the body begins producing proteins called thyroid stimulating proteins. These proteins 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 get larger and push the eyes forward. Usually both eyes are affected.

Almost all people with Graves’ eye disease have symptoms of an overactive thyroid. That includes anxiety, tremors, difficulty sleeping, weight loss despite an excellent appetite and heat intolerance.

Another rare cause of exophthalmos is early childhood glaucoma. 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:

  • Injury
  • Bleeding behind the eye
  • A blood clot behind the eye
  • A tumor

Your husband should make an appointment with his doctor. He will likely need to see an eye specialist if he truly has exophthalmos.

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