Eye bulging, or proptosis, occurs when one or both eyes protrude forward from the orbit more than normal. It can signal underlying orbital or systemic disease.
Causes
Thyroid eye disease is the most common cause in adults, leading to enlargement of muscles and fat behind the eye. Other causes include orbital tumours, inflammation or infection (cellulitis), vascular malformations, and trauma‑related bleeding.
- Unilateral, painful, or rapidly progressive proptosis is particularly concerning
- Children with sudden bulging may have infection, haemorrhage, or tumour
- Associated signs include lid retraction, double vision, and exposure symptoms
- Systemic features such as thyroid dysfunction or fever help narrow causes
Need for Urgent Evaluation
Proptosis often requires prompt imaging and specialist referral to determine the cause and protect sight. Severe cases can threaten the optic nerve or cornea.
- Redness, pain, and reduced eye movements suggest orbital cellulitis, an emergency
- Smoking cessation is crucial in thyroid eye disease
- Treatment varies from antibiotics and steroids to surgery or radiotherapy
- Regular monitoring tracks changes in severity and optic nerve function
