I have bulging eyes and it makes me feel very conscious of my appearance. (photos)

Question

I've had thyroid tests in past and it has come back normal. Is there anything that can be done to reduce the eye bulge?

Mehryar (Ray) Taban, MD, FACS · Answer

It appears you have significant inherited bulging eyes, likely due to shallow orbit, poor maxillary bone support, and/or large eyeballs. Improvement is definitely possible through orbital decompression surgery, orbital rim implant, or combination. Need to see expert orbital surgeon. See following website like and video. Skype consult available.

Robert H. Woods, MD · Answer

Sure looks like Grave's disease, in which the muscles of the eye get enlarged and cause the protrusion of the globes of your eyes. This can be improved with endoscopic decompression of the orbital fat be removing the bone between the ethmoid sinus and the maxillary sinus, incision the fibrous barrier and allowing the fat to protrude into the sinuses, thus relieving much of the pressure on the globe. This should be done in conjunction with an ent and an ophthalmologist as you may need some adjustments to your vision following this. Start with the eye doctor and endocrinologist.

Byron A. Long, MD · Answer

You do have a condition called proptosis and the most common cause of this is Hyperthyroidism. Very often when patients prensent with this condition their thyroid test are normal or even low. The eyes sometimes begin to bulge even up to a year after the thyroid hormones were elevated. You need to have an orbital CT scan to make sure there is nothing abnormal in the orbit and if it shows that the muscles around the eye are enlarged which would mean that it is related to the thyroid. Otherwise an orbital decompression and reconstruction along with eyelid surgery down the road would help with the appearance.

Matthew Sniegowski, MD · Answer

Thank you for your question.
There are a variety of reasons that eyes can either be or appear to bulge, as you mentioned, thyroid eye disease is one of the most common reasons that a patient may have protrusion (exophthalmos) of their eyes. However, some patients naturally have a more shallow orbit and more prominent eyes. Looking at the photos you supplied, I suspect you will have several options. It appears that you have a little more of the whites of your eyes showing on the lower part of your eye, one option to attempt to mask or make the eyes appear less prominent would be to have the lower eyelids elevated. Ultimately, more volume can be created in the orbit by sculpting some of the bone. I would recommend finding an Oculoplastic Surgeon in your area to discuss your options with.

Sara A. Kaltreider, MD (retired) · Answer

Patients may have normal thyroid testing and yet have thyroid-related proptosis (euthyroid ophthalmopathy). The bulging (proptosis or exophthalmos) may be treated with surgical decompression of the orbits. The eyes may not return to a totally normal position, but the surgery relieves pressure sensation behind the eyes, prevents them dryness secondary to exposure, and greatly improves the appearance. Decompression may be done for visual symptoms or comfort (many patients experience problems pulling clothing over the head). There are risks, but the surgery may be done safely and effectively by an experienced oculoplastic/ orbital surgeon. Often the upper eyelids will require retractor recessions to adjust the eyelid position after decompression. Your best approach is consultation with an oculoplastic surgeon whether this is related to thyroid issues or hereditary issues. Best wishes.

Devinder S. Mangat, MD, FACS (retired) · Answer

The appearance of your eyes is hereditary and as long as your Thyroid function tests were normal, there is not a lot that can be done to make them look less bulging.  A Consultation with an Ophthalmic Plastic Surgeon may be beneficial to see if an Orbital Decompression would be indicated although for non Thyroid condition, it is unlikely that a decompression will be recommended.

I have bulging eyes and it makes me feel very conscious of my appearance. (photos)

Answers (6)

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