Protruding Eyes

Protruding Eyes in Olympia

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.

American Family Vision Clinic

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. Zurcher 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 (360) 491-2121. Patients searching for advanced medical eye care visit our clinic from all over Washington, and we are proud to be a leading provider of medical eye care services for patients from Olympia, Lakewood, Tacoma, and Lacey.


Such a nice optician. My grandson is only 4 and needs glasses. We were so sad, but he explained the issues, and we will follow up as he suggested.

Anna P.

I had such a good experience with the clinic. Very friendly staff and doctor, did not have to wait for long to be called, and was treated respectfully. Thanks, American Family.

June S.

Dr. Zurcher has gone above and beyond what any other eye doctor has ever done to figure out what is going on with my eyes. Very happy with American Family Vision.

Christine R.

Family Vision Clinic changed our lives! My daughter was frequently car sick, and she was getting headaches every day, often painful enough that they brought her to tears. We saw a string of doctors and therapists, but we made no progress. Finally, we found Dr. Levi Zurcher and his eye therapist Rain. After ten weeks of eye therapy my daughter no longer gets headaches, and she no longer gets car sick. Daily tears are a thing of the past. I really can’t say enough about this clinic. It was fascinating to watch Dr. Zurcher work. For the first time, someone who knew what they were doing was intently studying my daughter, really trying to figure out all of her eye issues, and his therapist Rain is one of the most patient and lovely people that I’ve ever had the good fortune to meet. We’re finished with eye therapy—yay!—and I have switched to American Family Vision Clinic for all of my family’s other eye health needs.

Lars Wulff

Very professional, yet kind and helpful. They do what they can to make the appointment comfortable. I was running a bit late, I made sure ti call. They were able to switch me with a patient who was already there, they treated me with respect, and helped my son have confidence by getting him the eye care he needed that day. Thank you so much! Would recommend to anyone. It's a blessing that they care enough to work with people who have all different types of insurance from work to state coverage.

Justin E.

The staff is friendly. The Doc is very knowledgeable. The office is family friendly and everyone is so patient with the little ones.

Amy Fagerness
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