Bulging Eyes, Thyroid Eye Disease 

Bulging eye from thyroid eye disease is one of the most common conditions Dr. Eftekhari treats. Many patients in the general population have thyroid disease, and high thyroid or Graves’ disease is a common condition. In Graves’ disease, patients may experience weight loss, palpitations, tremors, and other symptoms. About half of patients with Graves’ disease will also develop changes around their eyes – bulging eyes, puffiness, swelling, and overall change in appearance. The eyes get swollen and bulging because some patients develop abnormal antibodies that cause growth of the eye fat and muscular tissue in the eye socket. In some cases, this can cause scarring and permanent vision loss or double vision.

Symptoms of Thyroid Eye Disease

At first it can be hard to understand why your thyroid dysfunction would cause eye puffiness. Many patients say their eyes have more tearing, redness, irritation or swelling around their eyes. Sometimes patients notice that one eye bulges. If you have these symptoms, call our office for a consultation.

More severe cases of thyroid eye disease can cause significant bulging of one or both eyes (proptosis). They can also get an abnormal appearance of the eyelid called eyelid retraction. This can occur in the upper eyelid – where it looks as if something pulled the windowshade of the eye too high. It can also happen in the lower eyelid, where the white of the eye shows below the eye. Rarely, patients can get double vision because of a scarred eye muscle.

Typical Course of Thyroid Eye Disease

In many patients, the signs and symptoms of thyroid eye disease increase and peak over the course of a few months, and then stabilize. This process can take 18 to 24 months to run its course, although there is significant variability. In almost all patients, their eyes may get a little bit better but do not return to their previous state or appearance.

Treatment for Bulging Eyes

Dr. Eftekhari treats many patients who have thyroid eye disease. In the past, weekly steroid infusions or oral steroids were the standard of care. Both of these types of treatments have side effects. For some patients, there is a new medication for thyroid eye disease. In 2020, the FDA approved Tepezza (teprotumumab) as the first medication approved specifically for thyroid eye disease. Dr. Eftekhari has published research articles on this medication. Depending on your severity, Dr. Eftekhari may prescribe this medication for you.

For patients who do not respond to medical therapy or who have scarring, Dr. Eftekhari performs surgery as in the above photo. Some surgery creates more space in the eye socket for the bulging eye to sit farther back into the eye socket (orbital decompression). Other surgery addresses abnormalities of the eyelids (eyelid retraction surgery). Dr. Eftekhari has extensive experience performing these surgeries. Dr. Eftekhari is board-certified and is a member of the International Thyroid Eye Disease Society (ITEDS) and the American Society for Ophthalmic Plastic and Reconstructive Surgery (ASOPRS).

If you have thyroid disease and have noticed changes around your eyes, call our office for a consultation.