Orbital Proptosis (Bulging Eye) Symptoms Houston TX | ENT Specialist
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Orbital proptosis, or a bulging eye or eye(s), can be a result of a condition called Grave’s disease. This disease primarily affects the thyroid gland and is considered an autoimmune disease. It can also impact the eyes making them appear to “bulge out” and create an unwanted appearance. Other causes of orbital proptosis include orbital tumors and these usually make only one eye appear to bulge or seem enlarged compared to the other “normal” eye. Orbital proptosis is a very serious condition because it can be due to either an orbital tumor or an autoimmune disorder that over time can cause loss of vision. For such serious problems you need to see a nose and sinus specialist at Houston Advanced Nose & Sinus. Dr. Kuperan is one of the few fellowship certified Rhinologists in all of Texas with specialized expertise, experience, and skills in treating patients with all types of orbital proptosis.


The two major causes of orbital proptosis are orbital tumors and Grave’s disease. Orbital tumors generally only cause one eye to appear enlarged or proptotic. Usually patients with Grave’s disease are under the care of an endocrinologist who is managing their elevated hyper-functioning thyroid gland (hyperthyroidism). Grave’s disease is an autoimmune disorder that means your body is attacking itself. There are molecules the body creates called antibodies that attack the thyroid gland and in some cases the fat surrounding the eyeball. When this orbital fat is targeted by the antibodies it causes hypertrophy with production of glycosaminoglycans and makes the eye appear to protrude out of the eye socket. This is called Grave’s orbitopathy and it usually affects both eyes. In addition to the unwanted appearance it creates, Grave’s orbitopathy can also lead to double vision and/or corneal irritation and abrasions over time because the eyelid is unable to cover the enlarged bulging eye completely. Concerning symptoms associated with orbital proptosis include:

  • Bulging of either one or both eyes creating an abnormal appearance
  • Double vision

  • Inability to completely close one or both eyelids
  • Excessive irritation or scratchy feeling on the surface of the eye with redness or excessive tearing


If you have signs or symptoms of orbital proptosis it is critical to consult a Rhinologist immediately for an accurate diagnosis and treatment plan. The initial evaluation will consist of an examination of the eye(s), laboratory testing for elevated thyroid antibody levels, and a nasal endoscopy (looking inside the nose with a small camera) to determine if a sinus tumor is invading into the orbit. Next, and MRI of the orbit is performed to determine if there is a tumor mass in the orbital cavity causing the proptosis. For orbital neoplasms that are medial to the optic nerve we can safely perform transnasal minimally invasive endoscopic orbital tumor resection. This approach is done through the nose without any visible scars or incisions. For orbital proptosis due to Grave’s disease we can perform minimally invasive transnasal endoscopic medial orbital decompression surgery. This approach is done through the nose without any visible scars or incisions and it allows the excessive orbital fat to reposition and significantly decreases the proptosis. The key is choosing an approach tailored to the severity and cause(s) of your orbital proptosis.There is not one single solution that is correct for every patient, and that’s why Houston Advanced Nose & Sinus is unique. We don’t promote a “cookie-cutter” approach to treatment like some other practices. Dr. Kuperan’s super specialized expertise and experience as a Rhinologist will make sure you get the best treatment to quickly resolve your orbital proptosis.