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    The most common cause of exophthalmos is Graves' disease, overactivity of the thyroid gland. The contents of the orbits swell due to inflammation, forcing the eyes forward. The inflammation affects primarily the muscles. This combination of muscle impairment and forward displacement reduces eye movement, causing double vision and crossed eyes (strabismus). The optic nerves can also be affected, reducing vision, and the clear membrane (conjunctiva) covering the white part of the eyes and lining the inside of the eyelids can swell. Finally, the eyes may protrude so far that the eyelids cannot close over them, leading to corneal damage.

    Exophthalmos from Graves' disease is bilateral (occurring on both sides), but not necessarily symmetrical. In contrast, exophthalmos from orbital tumors or a blood clot in the brain happens on only one side.

    Source: The Gale Group. Gale Encyclopedia of Medicine, 3rd ed.";

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