Which ocular feature is commonly associated with Graves disease?

• A. Red conjunctiva only
• B. Painless blurred vision
• C. Decreased tear production
• D. Bulging eyes

Answer: (D)

Graves disease often affects the orbit, with autoimmune inflammation and expansion of the tissues behind the eye. This increased volume inside the socket pushes the eyeball forward, producing exophthalmos or bulging eyes. Along with this forward displacement, lid retraction and sometimes double vision from impaired extraocular muscles are common parts of the orbital involvement. Other ocular signs like red conjunctiva alone, painless blurred vision, or decreased tear production can occur with many eye conditions and do not capture the typical Graves ophthalmopathy. The bulging eyes jab at the hallmark of this condition because it directly reflects the orbital tissue expansion beneath the eyelids.