What Causes Bulging Eyes (Exophthalmos)?

Medically Reviewed by Poonam Sachdev on February 15, 2024
4 min read

Bulging eyes, also called exophthalmos, is when your eyes protrude, or stick out more, than normal. Bulging eyes could be the result of another health or medical condition. You should see a doctor right away if your eyes start suddenly bulging and you have changes to your vision, a bad headache, or you feel sick. 

Exophthalmos vs. proptosis

While exophthalmos only affects your eyes, proptosis is a condition where any organ is bulging.

Bulging eyes, can be a sign of infection, thyroid problems, or other medical issues. It's important to get it checked by a doctor so you can start treatment for the condition that's causing it.

Thyroid eye disease is the leading cause of bulging eyes. It affects about 30% of people who have the immune system disorder called Graves' disease. If you have Graves' disease, your body makes too much thyroid hormone.

Anyone can get Graves' disease, but it typically affects women before age 40.

Though less common, Graves' eye disease can also happen to people with an underactive thyroid gland. In rare cases, people with normal thyroid levels can get it, too.

Why does Graves' disease cause bulging eyes?

With thyroid eye disease, your immune system – the body's defense against germs – attacks tissue around the eyes. This causes them to swell and push forward, giving them a bulging appearance.

An eye injury can cause swelling or bleeding in your eye socket. Your eye may bulge when blood collects behind it.

Other signs of an eye injury include:

  • Constant pain
  • One eye that doesn't move as well as the other
  • The feeling that something is in your eye
  • Vision changes, such as problems seeing out of the hurt eye

Your doctor will treat the injury and drain any fluid that has collected.

Many infections can attack the eye and inflame your eye socket.

A common infection of the eye is orbital cellulitis. It can lead to more serious problems if you don't get treatment. Along with bulging eyes, symptoms include:

  • Swelling of the eyelid
  • Pain
  • A hard time moving the eye
  • Fever
  • Redness in or around the eye

Call your doctor if you think an infection is the cause of your bulging eye. You could need antibiotics or possibly surgery.

In this eye disorder, increased pressure in the eyes damages the nerves that connect the eyes to the brain. Usually, this doesn't have symptoms, but in severe cases, the pressure can cause the eyes to bulge.

Other symptoms include extra tears and being sensitive to light.

Because there are usually no symptoms early on, it is important to get checked and treated for glaucoma to prevent vision loss. Your doctor will prescribe medication to lessen the pressure on your eyes. You might also need surgery.

A tumor can form behind the eye and force it forward. It can be cancerous (malignant) or noncancerous (benign). Other signs of a tumor behind the eye include:

  • Numbness, tingling, or pain in the eye
  • Vision changes
  • A swollen or droopy eyelid
  • You can't move your eyes in sync with each other, leading to double vision.

Doctors can remove some tumors with surgery. If the tumor is cancerous, you might need surgery, radiation, or chemotherapy.

Symptoms of bulging eyes include:

  • A dry, gritty feeling in your eyes
  • Pressure or pain in your eyes
  • Puffy eyelids
  • Red or inflamed eyes
  • Sensitivity to light
  • Double vision or vision loss

If you have any of these problems, see your doctor. They'll treat your specific eye symptoms as well as your thyroid hormone levels.

To figure out what's causing your bulging eyes, your doctor will ask about your symptoms and medical history. An exam of your eye could include:

  • Getting a close-up look at your eyes using a slit lamp
  • Evaluating the movement of your eye and eyelid
  • Looking for redness, pain, and discomfort

You may also need some other tests such as:

  • Exophthalmometry, which measures how far your eyeball sticks out from your eye socket
  • Blood tests, including a test for thyroid disease
  • Imaging, such as an MRI or a CT scan, to look for bleeding, tumors, or signs of infection
  • Blood or tissue culture to check for an infection

Treatments for bulging eyes include:

  • Artificial tears in the form of drops or a gel
  • Antibiotics for an infection
  • Treatments for the root cause of your condition, like hyperthyroidism
  • Corticosteroids or teprotumumab (Tepezza) for thyroid eye disease
  • Double vision treatments
  • Drugs that suppress your immune system
  • Surgery to create more space behind your eye and treat other symptoms and conditions

How to fix bulging eyes naturally

  • When lying down, use pillows to prop up your head.
  • Wear sunglasses to shield your eyes from bright light.
  • Give your eyes a break from contact lenses and switch to glasses.

If you have signs of bulging eyes – your eyes protrude from their sockets, pain, dry eyes, redness, or sensitivity to light – it's important to see a doctor to find out what's causing the condition. Your doctor will examine you and run one or more tests to figure out if you could have thyroid eye disease, another health issue, or an injury. While there are some natural ways to ease bulging eyes, the most common treatments involve eyedrops and other medications. Some people may need surgery to treat the condition.