Exophthalmos, also termed proptosis or bulging eyes, is primarily symptomatic of Grave’s disease. This autoimmune condition affects the thyroid gland, leading to an excessive release of thyroid hormones. When these hormones accumulate in muscles and fatty tissues behind the eyes, they cause the eyes to bulge.

What Causes Exophthalmos?

The most frequent cause of exophthalmos is Grave’s disease. When thyroid hormones overproduce due to this autoimmune disorder, it leads to abnormalities across various organs, including the eyes. As these hormones gather behind the eyes, they induce swelling in the eye sockets.

This results in the eyes protruding, a change that manifests slowly but becomes significantly visible over time. A few patients may also observe double vision and unusual eye movements.

Side Effects of Exophthalmos:

  • Vision Impairment: This can range from reduced vision to double vision.
  • Eye Discomfort: Patients may experience symptoms like sore eyes, redness, irritation, and dryness.
  • Tears: There can be an overactivity of the tear ducts.
  • Eye Pressure: A feeling of pressure can develop behind the eyes.
  • Eye Alignment Issues: Conditions like crossed eyes can emerge.
  • Glaucoma: Increased pressure within the eye.
  • Eyelid Issues: Inability to shut the eyes fully and retracting eyelids are common. This means the upper eyelid might sit higher, and the lower one could rest lower than usual.

Treating Exophthalmos Caused by Thyrotoxicosis:

To effectively treat exophthalmos resulting from thyrotoxicosis, it's crucial to simultaneously manage both conditions. Patients should consult an endocrinologist to maintain their hormones at regulated levels, facilitating successful exophthalmic treatment.

Initially, treatment for exophthalmos is symptomatic, with symptom changes noted every 2-3 months. If the patient develops complications such as double vision, crossed eyes, or eyelid irregularities, considering steroid medication might be beneficial.

As time progresses, exophthalmos usually begins to resolve, typically within 1 ½–2 years from onset. While some patients might witness full recovery or diminished eye bulging, others might continue to experience pronounced bulging.

In these cases, especially if initial treatments prove ineffective, surgical intervention can be sought. Expert ophthalmologists, specialising in orbital and cosmetic eye surgeries, can perform corrective procedures for pronounced eye bulging.