What is exophthalmos?

It is the projection or bulging of the eyeball outwards (proptosis), which may give the impression of “bulging eyes”. This may affect one eye or both, depending on the causes.

What causes it?

In a high percentage of cases, exophthalmos is associated with thyroid orbitopathy, an inflammatory disease related to hyperthyroidism.

The disease may be very serious, since the orbit is a non-extensible osseous cavity, in which an inflammatory process such as this can compress the optic nerve and cause blindness.

Other processes, which may cause exophthalmos, are orbital tumours, a large eyeball, high myopia or congenital glaucoma, as well as other thyroid or inflammatory orbital diseases.

Hyperthyroidism can cause exophthalmos

How can it be prevented?

In some cases, in its initial stages, exophthalmos can only be detected using imaging techniques.

Patients with hyperthyroidism problems should see an ophthalmologist, since the visual organ is a target for diseases related to hyperthyroidism.

Even today, if the associated eye problem is not obvious, the endocrinologist may not refer the patient to a specialist ophthalmologist.

However, statistics show that diseases associated with exophthalmos, such as thyroid orbitopathy, occur particularly in young women and smokers. It has been proven that tobacco, although not a direct trigger, aggravates these diseases, so it is important to avoid it.


Patients may present:

  • Upper eyelid retraction, which gives the face a look of shock or surprise.
  • Ocular irritation and reddening of the orbital and conjunctival tissues.
  • In inflammatory cases, such as thyroid orbitopathy, the exophthalmos may be accompanied by strabismus (deviation of an eye) and diplopia (double vision). This is due to thickening of the extraocular muscles, as well as a significant loss of vision due to compression of the optic nerve.

Associated treatments

Depending on the causes, the evolution and the prognosis of each patient, there are different strategies for treating exophthalmos:

Protective measures to combat the symptoms. Use of artificial drops, sunglasses when out on the street or sleeping with your head raised to avoid the accumulation of fluid in the eye.

Medical treatment. With corticosteroids and/or immunosuppressants.

Surgical treatment. This is necessary when there is a serious compromise in visual acuity due to the optic nerve. The main surgery focuses on decompression of the orbit, with the aim of increasing its capacity. If there is double vision, after a while, this surgery may be complemented with surgery of the retro-ocular muscles. Current orbital surgery addresses the ocular, aesthetic and functional problems in patients with orbital problems, such as exophthalmos, and recovers the vision, if this has been affected, as long as action was taken in time.

IMO Institute of Ocular Microsurgery

Josep María Lladó, 3
08035 Barcelona
Phone: (+34) 934 000 700
E-mail: international@imo.es
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By car

GPS navigator coordinates:
41º 24’ 38” N – 02º 07’ 29” E

Exit 7 of the Ronda de Dalt (mountain side). The clinic has a car park with more than 200 parking spaces.

By bus

Autobus H2: Rotonda de Bellesguard, parada 1540

Autobus 196: Josep Maria Lladó-Bellesguard, parada 3191

Autobuses H2, 123, 196: Ronda de Dalt – Bellesguard, parada 0071

IMO Madrid

C/ Valle de Pinares Llanos, 3
28035 Madrid
Phone: (+34) 910 783 783
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Public transport

Metro Lacoma (líne 7)

  • Lines 49 & 64, stop “Senda del Infante”
  • Line N21, stop “Metro Lacoma”


Patient care:
Monday to Friday, 8 a.m. to 8 p.m.

IMO Andorra

Av. de les Nacions Unides, 17
AD700 Escaldes-Engordany, Andorra
Phone: (+376) 688 55 44
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IMO Manresa

C/ Carrasco i Formiguera, 33 (Baixos)
08242 – Manresa
Tel: (+34) 938 749 160
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Public transport

FGC. Line R5 & R50 direction Manresa. Station/Stop: Baixador de Manresa


Monday to Friday, 08:30 A.M – 13:30 PM / 15:00 PM – 20:00 PM

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