My Eyes Have Become my Greatest Problem (photo)

Question

Ive always had sleepy eys.But really my eyes bulge profusely.I take eye drops but they are not working.My eyes still burn everyday.Awake or a sleep.As you will see in the picture that i provide, my eyes bulge so much that the lid can barely reach over to close.My eyes cant close.The ophthalmologst that i consulted said that lifting my eyelid would be bad and i wouldnt be able to close my eye.Ive been researching and believe that problem is the eyeball and not the lid.Please help!I

A.J. Amadi, MD · Answer

Proptosis is the medical term used to describe bulgy eyes. It usually happens when the contents of the eye socket are too big for the bony volume of the eye socket. If you eyes have had this appearance your whole life, this is likely an anatomic variant that is sometimes referred to as a "shallow orbit".

	This is not uncommon in the African-American demographic.

	If your bulginess has increased over time, then it could be related to Thyroid Eye disease.

	 

	There is surgery, called Orbital decompression, than can improve the appearance of the eyes and also improve your symptoms of dryness, or tearing. This is done by expanding the volume of the orbit [eye socket] by removing some of the bony walls. This can be done by experience Oculoplastics surgeons and sometimes by Craniofacial plastic surgeons.

	You can find a well trained Oculoplastics surgeon on the website ASOPRS dot org.

	Do not be discouraged. Seek a consultation.

	Best of luck to you.

Mehryar (Ray) Taban, MD, FACS · Answer

You have proptosis. In your case, it appears it is genetic (with shallow eye socket and poor malar/cheek bone support), although thyroid eye disease should always be considered. When proptosis is significant enough, then one cannot properly blink or close eye completely, thereby the eyes get dry and irritated. The most effective surgical treatment is orbital decompression. Consult an oculoplastic surgeon.

Larry S. Nichter, MD, MS, FACS · Answer

Your bulging eyes are technically called exophthalmos or proptosis. It can be a congenital problem (shallow orbits) or acquired from hyperthyroidism. The ophthalmologist you went to gave you reasonable advise. To correct this typically a 3D CT scan is done as part of your work up as well as some basic tests (to rule out thyroid or other problems). Probably the best place to be seen is at a multidisciplinary Craniofacial Team - often found in conjunction with large medical centers or University affiliated training programs. The orbital decompression/reconstruction of your orbit is complex and the opinion of the different specialists there including Plastic Surgeons and Oculoplastic Ophthalmologists would be helpful.

Sam Goldberger, MD · Answer

I agree with the others that your problem is proptosis. It can be repaired if you want. See an Oculoplastic surgeon who can work-up your condition and then give you a good recommendation. Good luck.

Matheson A. Harris, MD · Answer

It appears from your pictures that you have very shallow eye sockets, which is more common in African-Americans. This is often accompanied by some upper eyelid ptosis (droopiness) and lower eyelid retraction. Some people, as you mentioned, even have a condition called lagophthalmos, which means their eyelids don't completely close. Conservative treatments would involve using tears during the day and ointment at night to keep the eyes moist. Blocking off the tear drains with silicone plugs could also help. In more extreme cases, surgery is done to make the eye socket larger (orbital decompression). This allows the eye to settle backward. This is a big surgery and risks, but can be effective in reducing the bulging appearance. The lower eyelid could also be raised with a graft from the ear or with synthetic implants. Find a good oculoplastic surgeon to discuss your options.

Francis R. Palmer, III, MD (retired) · Answer

Has your eye doctor done an evaluation of the exophthalmos (bulging eyes)?  Thyroid and other medical causes could be making the eyes bulge and you should be evaluated to rule these out.

My Eyes Have Become my Greatest Problem (photo)

Answers (6)

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