What Is Thyroid Eye Disease? (Also Known as Graves’ Disease)
Hyperthyroidism is simply the overproduction of thyroid hormone. Graves’ disease is the most common cause of hyperthyroidism. Graves’ disease is an autoimmune disorder, where the immune system mistakenly attacks healthy tissues. In this case, the disease causes the immune system to create antibodies that trigger the thyroid to grow and overproduce thyroid hormone. Graves’ disease has many symptoms, from weight loss to heat intolerance, from muscle weakness to the development of a goiter. At the Longwood Eye & LASIK Center, we are concerned with Graves’ disease when it affects the eyes, a condition known as Graves’ ophthalmopathy.
In Graves’ ophthalmopathy the tissues and muscles behind the eyes become swollen. This swelling makes the eyeballs protrude forward beyond the normal range. This may or may not occur with other symptoms of hyperthyroidism.
Thyroid Eye Disease Symptoms
When a person has Graves’ ophthalmopathy, they will develop one or more of these symptoms:
- Bug eyes
- A staring look
- Dry, itchy, irritated eyes
- A gritty sensation in the eyes
- Sensitivity to light
- Watery, teary eyes
- A feeling of pain or pressure around the eyes
- Difficulty fully closing the eyelids
- Double vision, especially when looking to the side
What Causes Thyroid Eye Disease?
This condition results from the buildup of certain carbohydrates in the skin. Why this happens is unknown. The same antibody that triggers the hyperthyroidism seems to have an attraction, of sorts, to the tissues surrounding the eyes. Graves’ ophthalmopathy is usually related to thyroid overproduction, but it can occur without it.
It appears there is a genetic factor that makes certain people more susceptible. The condition usually develops in people under the age of 40. Also, women are much more likely to develop Graves’ disease than men. Stress, pregnancy, and smoking also increase a person’s risk.
How Is Thyroid Eye Disease Diagnosed?
When determining if you have Graves’ disease, the team at the Longwood Eye & LASIK Center will examine your eyes checking for irritation and protrusion. We’ll check if your thyroid gland feels enlarged. A blood sample will determine your levels of thyroid-stimulating hormone and the levels of thyroid hormones. If we need confirmation, we may order imaging tests such as CT scans or MRIs.
Thyroid Eye Disease Treatment Options
Mild symptoms such as eye irritation may be managed with artificial tears during the day and lubricating gels at night. Often these minor symptoms can resolve themselves in one to four months.
For more severe symptoms, we may use these treatments:
Prescription corticosteroids, such as prednisone, can diminish swelling behind the eyeballs.
Prisms in eyeglasses can correct the double vision that is occurring due to the disease.
Orbital decompression surgery
If increasing pressure on the optic nerve threatens the loss of vision, we may opt to remove the bone between your eye socket and your sinuses. This gives your eyes room to move back to their original position deeper in the face.