Thyroid Eye Disease

​Thyroid disease develops when the thyroid gland produces too little or too much thyroid hormones. Graves’ disease is a form of thyroid disease that involves an overproduction of thyroid hormones. It is considered an autoimmune disease because it occurs due to an abnormal immune system response. 

In some cases, Graves' disease can affect the eyes. According to the Mayo Clinic, about 30 percent of people with Graves’ disease develop thyroid eye disease. The condition, which is also called Graves ophthalmopathy, is thought to develop due to swelling and inflammation that promotes the production of fat and muscle tissue behind the eyes. Some people with Graves’ disease may develop eye symptoms as one of the first symptoms of thyroid disease. 

Symptoms 

Symptoms of thyroid eye disease vary. The condition can affect different parts of the eye. For example, swelling may affect the eyelids and give the appearance of baggy eyes. The eyelid muscles may also tighten, which may lead to other specific symptoms. Possible thyroid eye disease symptoms may include the following:

• Dry eyes
• Watery eyes
• Blurred vision
• Trouble closing the eyes
• Red eyes
• Bulging eyes
• Double vision
• Corneal ulcerations

The goods news is vision loss is uncommon with thyroid eye disease. According to the American Thyroid Association, although compression of the optic nerve and vision loss can occur, it is rare. 
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Risk Factors 

Anyone can develop Graves’ disease, which can lead to thyroid eye disease, but certain factors increase your risk, including those listed below. 

• Being female
• Having a family history of thyroid disease 
• Being middle-age
• Smoking 

Researchers are not entirely sure why some people that have Graves’ disease develop eye symptoms, and others do not. 
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Treatment of Thyroid Eye Disease 

Treatment for thyroid eye disease is often effective and can decrease problems and discomfort. The type of treatment needed depends on what symptoms develop and the severity. Thyroid eye disease treatment may include the following:

Treating thyroid hormone levels: The first step in treatment is to restore normal thyroid hormone levels. Medications are often prescribed that help return hormone levels to normal. Your primary care doctor will work with you to develop a treatment plan. In addition, your ophthalmologist can recommend treatment for your eye symptoms.

Eye drops: Eye drops are helpful to reduce scratchiness and dryness that can develop from an inability to close the eyes completely. For example, artificial tears may decrease discomfort and help keep the eyes lubricated. Talk to your eye doctor about which types of eye drops may work best and how often you can use them.

Prism glasses: Some people with thyroid eye disease develop double vision. According to the American Academy of Ophthalmology, prism glasses are sometimes helpful in treating double vision due to Graves’ disease. The glasses work by bending and redirecting the light before it travels to the eyes. The brain interprets each retina image and fuses it together as one image.

Selenium supplements: Some people with thyroid disease are thought to have low levels of the mineral selenium. But before taking supplements, it is best to talk with your doctor.

Sleep with your head elevated: Keeping your head elevated when you sleep may decrease swelling and help reduce the pressure on your eyes.

Quit smoking: According to the website Prevent Blindness, smoking increases a person’s risk of developing thyroid eye disease by up to eight times. It also decreases the effectiveness of treatment. So, if you smoke, it’s best to quit.

Eye surgery: If conservative treatment has not worked or if symptoms are severe, eye surgery may be recommended. Various types of procedures may be used depending on the problem. For instance, surgery to reposition the eyelids may help if a person cannot close their eyes completely. Eye muscle surgery is also an option to help correct double vision.

If you have questions about thyroid eye disease, please contact us. Additionally, if you would like to schedule an exam with one of our ophthalmologists, please call our office at 508-746-8600.