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Why do patients with hyperthyroidism develop exophthalmos (protruding eyes)?

Jul 19, 2025 Source: Cainiu Health
Dr. Yang Chuanjia
Introduction
Hyperthyroidism usually refers to hyperfunction of the thyroid gland. Under normal circumstances, patients with hyperthyroidism may develop exophthalmos (protruding eyes) due to various reasons such as excessive thyroid hormones, sympathetic nerve excitation, inflammation of periorbital tissues, retro-orbital fat proliferation, or lesions of the extraocular muscles. If discomfort occurs, timely medical consultation is recommended. A detailed analysis is as follows:

Hyperthyroidism usually refers to hyperthyroidism. Generally, patients with hyperthyroidism may develop protruding eyes due to various factors such as excessive thyroid hormones, sympathetic nerve stimulation, periorbital tissue inflammation, retro-orbital fat proliferation, or extraocular muscle disorders. If discomfort occurs, timely medical attention is recommended. Detailed explanations are as follows:

1. Excessive Thyroid Hormones

Elevated thyroid hormone levels can affect the metabolism of periorbital tissues, causing edema and tissue proliferation, which may lead to eye bulging. Follow medical advice to take medications such as Hyperthyroidism Spirit Tablets (Jia Xiang Ling Pian), Methimazole Tablets, or Propylthiouracil Tablets for treatment.

2. Sympathetic Nerve Stimulation

Hyperthyroidism can overstimulate the sympathetic nerves, increasing the tension of the extraocular muscles and levator palpebrae superioris muscles, pulling the eyeball forward. Maintain emotional stability and avoid excessive tension or anxiety. Emotional regulation can be achieved through calming music, meditation, and other methods to reduce triggers of sympathetic nerve excitation.

3. Periorbital Tissue Inflammation

Autoimmune reactions can cause inflammation of the periorbital tissues. Inflammatory stimulation leads to congestion and edema, pushing the eyeball outward, often accompanied by redness and dryness of the eye. Patients should take medications such as Methylprednisolone Tablets, Prednisone Acetate Tablets, or Cyclophosphamide Tablets under a doctor's guidance.

4. Retro-orbital Fat Proliferation

Deposition of immune complexes and other factors may cause retro-orbital fat proliferation, occupying orbital space and forcing the eyeball forward. This may be accompanied by blurred vision. After medical evaluation, drugs such as Compound Cyclophosphamide Tablets, Tacrolimus Capsules, or Methotrexate Tablets may be used to improve the condition based on individual circumstances.

5. Extraocular Muscle Disorders

Autoantibodies attacking the extraocular muscles can cause fibrosis and thickening of the muscles, restricting eye movement and pushing the eyeball outward. Severe cases may result in double vision. Prompt hospital visits are necessary to assess the extent of the condition. Under medical guidance, treatments such as Hydrocortisone Injection, Azathioprine Tablets, or Mycophenolate Mofetil Dispersible Tablets may be used.

In daily life, take care to protect your eyes by avoiding prolonged screen exposure; wear sunglasses when outdoors to reduce strong light and dust irritation; maintain eye hygiene and avoid rubbing the eyes with your hands.

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