Graves' disease is the most common cause of exophthalmos. Anywhere from 25-50 percent of people with this condition will have an eye involvement. Interestingly, eye involvement can occur up to 10 years before the diagnosis of thyroid problems is made and up to 20 years after.

What causes exophthalmos?

In adults, the most common cause of unilateral and bilateral exophthalmos is thyroid-associated eye disease, such as Graves-related ophthalmopathy. In children, orbital cellulitis is the most common cause, whereas bilateral exophthalmos is most likely due to neuroblastoma and leukemia.

What causes exophthalmos pathophysiology?

The most common cause for unilateral or bilateral exophthalmos is thyroid eye disease, or Graves ophthalmopathy. The proptosis arises from inflammation, cellular proliferation, and accumulation of fluid in the tissues that surround the eyeball in its socket, or orbit.