How Thyroid Disease Can Affect the Eyes | Thyroid Awareness Month

​January is Thyroid Awareness Month. Thyroid disease is a group of diseases of the thyroid gland. Thyroid disease can affect numerous bodily functions, from heart rate to metabolism. In some cases, it can also affect the eyes.
 
According to the American Thyroid Association, approximately 20 million people in the United States have some type of thyroid disease. Knowing the symptoms of thyroid disease is important to getting the right treatment and preventing complications.
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What Is Thyroid Disease?

​The thyroid gland produces a hormone that regulates vital bodily functions. The two most well known types of thyroid disease are hyperthyroidism and hypothyroidism. When too much thyroid hormone is produced, the condition is referred to as hyperthyroidism. When too little thyroid hormone is produced, it is called hypothyroidism. Both conditions can lead to a variety of symptoms.
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Symptoms of hypothyroidism include:

• Weight gain
• Dry skin
• Fatigue
• Muscle aches
• Thinning hair

Symptoms of hyperthyroidism include:

• Weight loss
• Nervousness
• Difficulty sleeping
• Fast heart rate

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How Thyroid Disease Can Affect The Eyes

​Usually, an underactive thyroid does not lead to eye problems. Hyperthyroidism, on the other hand, can be caused by a condition called Graves’ disease, which can affect the eyes. Graves’ disease involves an abnormal immune system response that leads to an overproduction of thyroid hormone and that releases an antibody that may target the tissues of the eye.

The exact reason Graves’ disease and increased thyroid hormone may affect the eyes is not fully understood. It appears the connective tissue within the eye socket contains proteins that are similar to those in the thyroid gland, which makes them vulnerable to the effects of Graves’ disease.

According to the Mayo Clinic, about 30 ​percent of people that have Graves’ disease develop symptoms related to the eyes. When Graves’ disease affects the eyes, the condition is called Graves’ ophthalmopathy.

The tissues around the eyes swell and become inflamed. Symptoms may include:

• Redness of the eyes
• Puffiness
• Eye pain
• Bulging of the eyes
• Restriction of normal eye movement
• Sensitivity to light
• Dry eyes

​The most serious complication of Graves’ ophthalmopathy is vision loss. If swelling becomes severe and the optic nerve becomes compressed, it can lead to decreased vision.
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Diagnosis of Thyroid Eye Disease

​A diagnosis of thyroid eye disease is often made based on symptoms, medical history, and an eye exam. A thyroid function test, a blood test to measure levels of the thyroid hormones, is also performed. The blood test can detect high levels of thyroid hormone and confirm a diagnosis of Graves’ ophthalmopathy.
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An eye exam is also an essential part of a correct diagnosis. An exam allows the eye doctor to determine the severity of inflammation and assess whether vision is threatened or compromised.
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Treatment of Thyroid Eye Disease

Treatment of thyroid eye disease is geared at decreasing complications that could lead to vision loss and easing symptoms. Compression of the optic nerve and ulcers of the cornea due to dryness are the most worrisome complications. Treatment may depend on the severity of symptoms and can include:

Taking Steroids
Steroids may be used to treat swelling and inflammation, both of which can affect the optic nerve and threaten vision. Medication may be given orally or intravenously, depending on the severity of the symptoms. Side effects of steroids may include weight gain, mood changes, and increased risk of infection. The risk of side effects often depends on the dose and the length of time the medication is taken.

Administering Eye Drops
Graves’ ophthalmopathy can also cause dry and irritated eyes. Eye drops can help add moisture and decrease discomfort.

Using Eye Pads
Some people may also have trouble closing their eyes completely even when sleeping, which also contributes to dry eyes. Wearing eye pads or an eye mask at night can help keep the eyes closed when sleeping.

Sleeping with the Head of the Bed Raised
Sleeping with the head of your bed raised or using a few pillows under your head may help to reduce swelling in the tissues around your eyes.

Wearing Special Glasses
Special glasses are available that can help decrease double vision that can develop with Graves’ ophthalmopathy.
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Avoiding Smoking
Smoking appears to make symptoms of Graves’ ophthalmopathy worse. If you smoke, talk with your doctor about methods to help you quit.
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Stabilizing Thyroid Hormone Levels

Taking medication that corrects an overproduction of thyroid hormone can stabilize levels. In many instances, when thyroid function is stabilized, symptoms of thyroid eye disease decreases.

If you have a thyroid condition, it’s essential to work with your doctor to keep hormone levels stabilized. It’s also vital to see your eye doctor regularly for comprehensive eye exams to spot any potential problems early and prevent complications. If you have any questions or would like to schedule an appointment with one of our eye doctors, please call our office at 508-746-8600.
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Stay tuned for the next blog when we cover “Traumatic Brain Injury Awareness and Vision.” Thanks for reading!