Protruding eyes; Exophthalmos; Proptosis; Bulging eyes
Bulging eyes is the abnormal protrusion (bulging out) of one or both eyeballs.
Prominent eyes may be a family trait. However, prominent eyes are not the same as bulging eyes. Bulging eyes should receive immediate attention.
Bulging of a single eye, especially in a child, is a very serious sign and should be evaluated immediately.
Hyperthyroidism (particularly Graves disease) is the most common cause of bulging eyes. With this condition, the eyes don't blink very often and seem to have a staring quality.
Generally, there should be no visible white between the top of the iris (the colored part of the eye) and the upper eyelid. Seeing white in this area is usually a good indication that there is abnormal eye bulging.
Because eye changes develop slowly, family members may not notice it until the condition is relatively advanced. Photographs often draw attention to the bulging when it may have gone unnoticed previously.
Davies TF, Larsen PR. Thyrotoxicosis. In: Kronenberg HM, Melmed, S, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008: chap 11.
Olitsky SE, Hug D, SMith LP. Orbital abnormalities. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th Ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 632.
Robinett DA, Kahn, JH. The physical examination of the eye. Emerg Med Clin N Am. 2008;26:1-16.