Eye Bulging

WHEN TO SEE YOUR DOCTOR

* You should always go to a doctor if your eyes begin to bulge.

What Your Symptom Is Telling You

If you have a permanently startled look, it can be a sign that you have a thyroid disorder known as Graves' disease.

The thyroid gland in people who have Graves' may be producing too much hormone. The body's immune system reacts by producing immune cells that attack the tissues and muscles of the eye. The tissues in the eye socket swell, pushing the eye forward and exposing the white. Then the muscles that move the eyes begin to thicken, which may throw the eyes out of alignment. The result is double vision.

With Graves' disease bulging may appear in one or both of your eyes. And because the lids don't completely cover the bulging eyeballs, your eyes can dry out, becoming scratchy and red, and they can be sensitive to bright light.

Other causes of bulging eyes include infections inside the eyeball, enlargement of blood vessels behind the eye and tumors.

Symptom Relief

Bulging of the eyes is a symptom that must be evaluated and treated by a doctor. If you have Graves' disease, you may need to take anti-thyroid medication until the disease goes into remission. As the disease is treated, the bulging will eventually recede, according to Thomas Hedges, M.D., director of neuro-ophthalmology at the New England Eye Center at the New England Medical Center in Boston. This could take a year or two. In the meantime, here's how to ease the problem.

Moisten your eyeballs. With more of your eye area exposed, you'll need to use over-the-counter artificial tears during the day, says Dr. Hedges. Use an ophthalmic eye ointment (available at pharmacies) at bedtime, covered with a homemade "moisture chamber." A small patch of plastic wrap placed over each eye works nicely, says Nancy Patterson, Ph.D., executive director of the National Graves' Disease Foundation in Jacksonville, Florida. (For other hints on keeping your eyes moist, see Eye Dryness on page 156.) If these simple measures do not relieve the dryness, and if the bulging is severe, a surgeon may be able to stitch the corners of your eyelids so they won't open all the way.

Don't abuse red-out eyedrops. While artificial tears are fine, eyedrops to take the redness out are not, cautions Dr. Hedges. These commercial drops eliminate redness by constricting blood vessels in the eye. Overuse—say for more than three days—can make the vessels overreact and give you rebound redness, says Dr. Hedges.

View the world through tinted glasses. They'll camouflage the protrusions and provide a shield from bright light and wind, says Dr. Hedges. (See Light Sensitivity on page 315.)

Raise your bed. If your bulging eyes are mild and your main complaint is swollen eyelids, you can put the head of your bed up on six-inch blocks. "This reduces the accumulation of fluid in the eyelids during the night," says Mitchell H. Friedlaender, M.D., director of corneal services in the Division of Ophthalmology at the Scripps Clinic and Research Foundation in La Jolla, California, and coauthor of 20/20: A Total Guide to Improving Your Vision and Preventing Eye Disease.

Lay off the saltshaker. Decreasing your intake of salt may help reduce fluid pressure, says Dr. Hedges. But don't take diuretics unless advised by your doctor, he adds.