Protruding Eyes

Protruding Eyes

Sometimes people may have eyes that appear to protrude forward, in which case it is important to book an appointment with your eye doctor who will diagnose the cause and check if there is any treatment necessary.

If your eyes are bulging out or they don’t seem to be in their normal position, it could be a sign of a medical condition and it must be checked as soon as possible. When the eyes protrude forwards, it’s referred to medically as exophthalmos. There are various causes of this condition, some more serious than others, and therefore it’s essential to consult with your eye doctor so that the proper diagnosis and treatment plan can be determined.

Some people are born with this problem while others tend to develop it over the course of their lifetime due to a medical problem. Normally the white part of the eye is not visible between the iris and the upper eyelid so in a case where it can be seen, there is most likely atypical bulging. The treatment prescribed by the eye doctor will depend on the cause of exophthalmos in the first place. 

If there is a sudden protrusion of one eye then this is considered to be an emergency and you need an immediate medical examination. This could be a symptom of a serious problem that needs to be resolved.

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When to see an Eye Doctor

If you are experiencing any warning signs, book an appointment with our office immediately. Even if you’re unsure whether or not you need an appointment, we will be happy to schedule an appointment for you as it’s best to get it checked out as soon as you can. 

Causes of Bulging Eyes

The primary cause of exophthalmos in adults is hyperthyroidism, a condition that occurs when the thyroid gland is overactive. This gland is present in the front of your neck and is responsible for the release of different hormones that regulate your metabolism. When the thyroid releases a high number of hormones, hyperthyroidism develops. Other causes of bulging eyes which will be discussed below include eye trauma, glaucoma or a tumor.

Graves’ Eye Disease

Graves’ disease is an autoimmune disorder that is recorded as the main cause of the development of hyperthyroidism and bulging of the eyes. When this condition is developed, the tissues of the eye tend to become inflamed and cause a protruding effect of the eye. 

Anyone can develop this disease, but women between the ages of 30 and 60 are especially likely to face this problem. Some of the other symptoms of Graves’ that can be coupled with exophthalmos include:

  • Dryness of the eyes
  • Pain 
  • Feeling of high pressure in the eyes
  • Puffiness of the eyelids
  • Redness
  • Inflammation 
  • Double vision 
  • Light sensitivity
  • Loss of vision

Eye Injury

When an individual gets an eye injury, in one way or another, it can lead to excessive bleeding and swelling in the eye which can cause exophthalmos. The eye doctor is likely to drain the fluid build up in the eye in order to treat it properly. 


Nerves are responsible for sending signals between the eyes and the brain. In glaucoma there is a high amount of pressure on the eye which damages these nerves and can lead to exophthalmos. 

Apart from the bulging, you might also experience symptoms like tearing and light sensitivity. Glaucoma left untreated may cause vision loss and therefore immediate treatment from an eye doctor is essential to prevent the progression of this disease. There are effective medications that your eye doctor can prescribe to treat glaucoma and in some cases if that’s not sufficient, surgery may be recommended to help preserve your vision.

Tumor Behind the Eye

Bulging can also be caused by the presence of a tumor behind the eye which can force the eye to move forward. It’s important to note that the tumor may or may not be cancerous, but you need treatment to have it removed and to stop the eye from protruding outwards. If it is linked to cancer, there are various types of this illness which can cause a tumor behind the eye. Some of the symptoms of a tumor behind the eye may include the following:

  • Tingling feeling
  • Numbness
  • Pain 
  • Vision problems
  • Droopy eyelid
  • Swelling
  • Difficulty moving both eyes together properly
  • Double Vision

Eye doctors can remove the tumor through surgery. In cases where the tumor cannot be removed, radiation or chemotherapy might be required in order to shrink the size of the tumor as much as possible.

Tumor Behind the Eye
Diagnosing the Cause of Exophthalmos

Diagnosing the Cause of Exophthalmos

You should seek urgent care from your eye doctor if you have the condition of a bulging eye in either one or both eyes. Your eye doctor will need a complete medical history before making any diagnosis. A list of the prescriptions that you are currently taking, supplements and other medications should also be highlighted when you give your information. 

Specifications about the various symptoms should also be shared. Some of these factors include:

  • Time or day when the bulging eyes were first noticed
  • Whether the condition has become better or worse since the first time it was seen
  • Presence of symptoms like changes in vision, headaches etc. 

Once a physical examination is done, the eye doctor might also have to do other tests to make the right diagnosis. Some of the possible tests include:

  • Vision test
  • Slit lamp exam (a microscope used to observe the surface of the eye)
  • Dilation of the eye
  • Blood tests
  • Imaging tests like CT or MRI scanning
Diagnosing the Cause of Exophthalmos

Treatment for Exophthalmos

The treatment plan is based on the identified cause of the bulging eye. As per the diagnosis given, the doctor may recommend one or more of the following treatments:

  • Eye drops
  • Antibiotics 
  • Corticosteroids
  • Surgery
  • Chemotherapy or radiation to treat tumors

If the diagnosis is concluded to be Graves' disease or certain other conditions related to the thyroid, then the treatment plan would involve specific medications for this condition. Alternatively, it may be treated by surgically removing the thyroid gland or by replacing the thyroid hormone. 

If you have hyperthyroidism, smoking can cause more damage. If the patient quits smoking, the symptoms can reduce drastically. Further, the eye doctor might give prescription drugs or therapies to replace nicotine and counselling sessions to help quit this habit.

Common Questions

The most common medical cause of bulging eyes is hyperthyroidism, particularly Graves disease. This disease affects one out of three people with overactive thyroid glands. Middle-aged women and smokers are most likely to suffer from it. When thyroid eye disease develops, the immune system attacks fatty tissues and muscles around the eye. Consequently, inflammation occurs, causing the bulge. Another common cause of bulging or protruding eyes is a disease that is called Keratoconus. This condition affects approximately 1 in every 2000 people in the US. While the exact cause of Keratoconus is unknown, genetics plays a large role in the incidence of this condition.
Protruding Eyes
Dr. Wernick cartoon


If you notice the condition of bulging eyes causing self-consciousness, there is psychological and emotional support available to provide for your overall health and well-being. Based on the underlying cause of the problem, you may be successful in getting the right treatment for the problem. Please don’t hesitate to book an appointment at our office to ensure that the necessary steps can be taken to diagnose and to treat exophthalmos. You can schedule an eye exam with our eye doctor by calling (212) 752-6930. Patients searching for advanced medical eye care visit our clinic from all over New York, and we are proud to be a leading provider of medical eye care services for patients from New York, Queens, Brooklyn, and Long Island.


At Amplify with Dr Wernick I was seeking help for seemingly intractable, probably age-related dryness. I've seen other doctors about it, and that has been helpful, but what he explained to me about it and the careful way he answered all my questions gave me so much more of a clear understanding of what is going on (and is not) that I am more able to implement all his and others' recommendations than I was before. And he gave me additional resources for further follow-up. I am most grateful.

Cynthia Norton

Wow! This is a great Eye Care medical facility. I was thoroughly examined by Dr. Pinkhasov for over 2 hours. She made sure to check my eyes for pretty much everything and patiently explained proper care for my eyes. They definitely know how to provide great care and treat their patients right. Now I know why they have such a great reputation and been around for so long.

Steve Fay

Dr. Kavner is a gifted diagnostician and orthoptic therapist. He treated me several decades ago for a condition similar to dyslexia. I was having migraines five times per week. I worked with him for about a year and I experienced tremendous improvement (down to 3-4 per year) that has lasted.

Mary K.

Dr. Kavner recommended two types of eye therapy for my daughter. One of them using bio-feedback. In just three sessions she is seeing considerably better. She shouted this morning: Ooh my God! I could not see these letters with my glasses on, and now I can see them without my glasses. If you are willing and able to invest in improving your vision, this is a good place to go to!

Peter G.

Dr. Kavner recommended two types of eye therapy for my daughter. One of them using bio-feedback. In just three sessions she is seeing considerably better. She shouted this morning: Ooh my God! I could not see these letters with my glasses on, and now I can see them without my glasses. If you are willing and able to invest in improving your vision, this is a good place to go to!

Kinkie F.

I have always found Dr Kavner's work, expertise and wisdom of the highest caliber. As one of the fathers of OT, occupational othomology, his depth and breadth of knowledge about the eyes' health and wellbeing of the patient is exemplary. Cannot say enough good things about him.

Allen B.
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